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WHINER S AGE A. WHINER S NAME Last First MI E. TYPE OF WHINE USED C. WHINER S SEX D. DATE OF REPORT F. NAME OF THE PERSON FILLING OUT THIS FORM PART II - INCIDENT REPORT A. DATE FEELINGS WERE HURT B. TIME OF HURTFULNESS D. WAS ANYONE SYMPATHETIC TO WHINER Please include paid witnesses F. HOW LONG DID YOU WHINE C. HURT FEELINGS REPORT To use this form it must be physically placed in the hands of any Law Enforcement Officer DATA REQUIRED BY THE PRIVACY ACT OF 1974 AUTHORITY S USC 301 Departmental Regulation 10 USC 3013 and a log of other regulations too PRINCIPAL PURPOSE To assist whiners in documenting hurt feelings ROUTINE USES DISCLOSURE Whiners should use this form to seek sympathy from someone who cares Disclosure is voluntary however repeated whining may lead to your file being stamped candy ass or some other appropriate term PART I - ADMINISTRATIVE DATA B. DID YOU REQUIRE A TISSUE FOR TEARS 4. HAS THIS RESULTED IN A TRAUMATIC BRAIN INJURY MULTIPLE PART IV - REASON FOR FILING THIS REPORT Mark all that apply I am thin skinned The Dept needs to fix my problems Two beers is not enough I am a wimp My feelings are easily hurt My hands should be in my pockets I have woman / man-like hormones I didn t sign up for this I was not offered a tissue I am a crybaby I was told that I am not a hero Someone requested a tissue I want my mommy The weather is too cold All of the above and more NARRATIVE Tell us in your own sissy words how your feelings were hurt as if anyone cared PART V - AUTHENTICATION A. WHINER S AGE A. WHINER S NAME Last First MI E* TYPE OF WHINE USED C. WHINER S SEX D. DATE OF REPORT F* NAME OF THE PERSON FILLING OUT THIS FORM PART II - INCIDENT REPORT A. DATE FEELINGS WERE HURT B. TIME OF HURTFULNESS D. WAS ANYONE SYMPATHETIC TO WHINER Please include paid witnesses F* HOW LONG DID YOU WHINE C. LOCATION OF HURTFUL COMMENTS E* NAME OF PERSON WHO HURT YOUR PANSY ASS FEELINGS G* WHICH FEELINGS WERE HURT PART III - INJURY Circle all that apply 1. WHICH EAR WERE THE HURTFULL WORDS SPOKEN INTO 2. IS THERE PERMANENT FEELING DAMAGE LEFT RIGHT YES BOTH NO MAYBE 3. PRINTED REPORTER NAME if you wish to be labeled too B. SIGNATURE are you sure about this C. PRINTED WHINER NAME you really are going out on a limb here D. SIGNATURE OF WHINER you have got to be shitting me We as the Dept take hurt feelings seriously. If you don t have someone who can give you a hug and make things all better please let us know and we will promptly dispatch a hugger to you ASAP. In the event a hugger cannot be found an EMS Team will be dispatched to soak your socks in coal oil to prevent ants from crawling up your leg and eating their way up your candy ass. If you are in need of supplemental support upon written request we will make every reasonable effort to prvide you with a blankie a binky and/or a bottle if you so desire. DATE FEELINGS WERE HURT B. TIME OF HURTFULNESS D. WAS ANYONE SYMPATHETIC TO WHINER Please include paid witnesses F* HOW LONG DID YOU WHINE C. LOCATION OF HURTFUL COMMENTS E* NAME OF PERSON WHO HURT YOUR PANSY ASS FEELINGS G* WHICH FEELINGS WERE HURT PART III - INJURY Circle all that apply 1. .

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