Stolen Valor Claim Report Form
Use this form to report suspected false claims about military service, honors, rank, medals, or related credentials. Provide as much factual detail and evidence as possible.
Reporter Information
Full Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
*
Email
Phone
Either
Subject of Report
Reported Person's Full Name or Alias
Organization or Unit (if known)
Approximate Age or Age Range (if known)
Your Relationship to the Subject
*
Acquaintance
Coworker
Family Member
Public Encounter
Online Profile
Other
Claim Details
Type of Military-Related Claim Observed
*
Service branch
Rank
Deployment
Combat experience
Medals or awards
Special forces
Veteran status
Other
Description of Statement or Behavior
*
Where Was the Claim Made?
When Was It Observed?
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Evidence and Witnesses
Evidence Type(s)
*
Photo
Video
Screenshot
Audio
Document
None
Supporting Evidence Files
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Witnesses
Additional Verification Details
Prior Reporting and Follow-up
Was this matter reported elsewhere before?
*
No
Yes
Unsure
Where was it reported?
Case or reference number
Preferred follow-up outcome or additional comments
Submit Report
Should be Empty: