Victim Complaint
Under the Declaration of Victims Rights (DVR), victims have a right to information, protection, participation and restitution. Any victim who is of the opinion that their rights under the DVR have been infringed or denied by an authority within the Military Justice System has the right to file a complaint through the Director of External Review (DER). To file a complaint, you may complete this form and/or send the information about your complaint to DER via one of the methods indicated below. Do not hesitate to communicate with us if you need more information about how to file a complaint.
Privacy Notice Statement
The information provided in this form is collected for the Department of National Defence / Canadian Armed Forces DVR complaint review
mechanism, for the purpose of addressing a complaint. All personal information in this document will be stored, protected, used and
disclosed in accordance with the Privacy Act.
Personal information collected through the processing of your complaint will be stored in accordance with the Privacy Act and can be
accessed and assessed for accuracy by sending a written request to DER at DERVictimsRights-DREDroitsdesVictimes@forces.gc.ca.
For more information, visit Information about programs and information holdings.
Victim Information
Part A: Victim Information
SN / PRI (if applicable)
Rank
- Adm
- Gen
- LGen
- VAdm
- MGen
- RAdm
- BGen
- Cmdre
- Capt(N)
- Col
- Cdr
- LCol
- LCdr
- Maj
- Capt
- Lt(N)
- Lt
- Slt
- 2Lt
- A/Slt
- Esgn
- NCdt
- OCdt
- CPO 1
- CWO
- CPO 2
- MWO
- Csgt
- PO 1
- WO
- PO 2
- Sgt
- MBdr
- MCpl
- MS
- Bdr
- Cpl
- S1
- S2
- Avr
- Cfn
- Dmr
- Fus
- Gdsm
- Gnr
- Mus
- Ppr
- Pte
- Pte(T)
- Rfn
- Sig
- Spr
- Tpr
- Volt
- S3
- Pte(B)
- Pte(R)
- Rgr
- Civilian
Surname
Given name(s)
DOB (yyyy-mm-dd) Title
Title
Unit (if applicable)
Part B: Additional Information
Address
Street
City
Prov. / Terr.
- AB
- BC
- MB
- NB
- NL
- NS
- NS
- NT
- NU
- ON
- PE
- QC
- SK
- YT
Country
Postal code
Telephone (work)
Telephone (home)
Preferred means of communication
Preferred language of communication
- English
- French
Email address
Name of victim liaison officer (if applicable)
Rank
- Adm
- Gen
- LGen
- VAdm
- MGen
- RAdm
- BGen
- Cmdre
- Capt(N)
- Col
- Cdr
- LCol
- LCdr
- Maj
- Capt
- Lt(N)
- Lt
- Slt
- 2Lt
- A/Slt
- Esgn
- NCdt
- OCdt
- CPO 1
- CWO
- CPO 2
- MWO
- Csgt
- PO 1
- WO
- PO 2
- Sgt
- MBdr
- MCpl
- MS
- Bdr
- Cpl
- S1
- S2
- Avr
- Cfn
- Dmr
- Fus
- Gdsm
- Gnr
- Mus
- Ppr
- Pte
- Pte(T)
- Rfn
- Sig
- Spr
- Tpr
- Volt
- S3
- Pte(B)
- Pte(R)
- Rgr
- Civilian
Surname
Given name
Are there any ongoing legal or administrative proceedings, that you are aware of, related to this complaint?
- Yes
- No
Part C: Complaint Information
Please indicate which of the following right(s) you are of the opinion that has / have been infringed or denied by an authority within the Military Justice System
- Right to Information
- Right to Protection
- Right to Participation
- Right to Restitution
Details of complaint
Please describe the remedy you are seeking through this complaint
Date (yyyy-mm-dd)
Signature
Once completed, please send the form to:
Director of External Review
Ref.: DVR
101 Colonel By Drive
Ottawa ON K1A 0K2
Or electronically at: DERVictimsRights.DREDroitsdesVictimes@forces.gc.ca
Useful links:
- Office of the Federal Ombudsman for Victims of Crime
- Sexual Misconduct Support and Resource Centre
- Complaint Solutions and Services
DND 4869-E (10-2022) WCAG 2.0