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Fraud Hotline Complaint Form

  1. Please complete this form to report suspected fraud or abuse. Answer the questions as completely as possible. Vague allegations may not be able to be substantiated. Please be as specific as possible. If you wish, you can supply information so that we may contact you, or you can remain anonymous. All information submitted will remain confidential.

  2. Please describe what has happened. Be as specific as you can.

  3. Enter the department, area, or vendor where the suspected fraud has occurred.

  4. Enter the name and title of the person(s) suspected of committing fraud, waste, or abuse.

  5. Enter the approximate date(s) when the fraud took place. Is it still going on?

  6. Please describe any evidence and where it can be found.

  7. Please enter an approximate dollar amount or value involved in the fraud.

  8. Enter name(s) of any other witnesses.

  9. Please include your name and contact information. It is not required that you identify yourself. However, without a means to contact you with follow-up questions, the investigation could come to a dead end. If you do not wish to identify yourself, we recommend that you set up an anonymous email account through an independent provider such as Hotmail, Yahoo, or Google in order for us to communicate with you.

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  11. This field is not part of the form submission.