DHS OIG Fraud, Waste, and Abuse Reporting Form

Your selection of one of the filing options below implies you have reviewed the information and understand the choice you are making.
Individuals who report allegations are not required to provide their identity to the Office of Inspector General (OIG). However, persons who report allegations are encouraged to identify themselves to help OIG evaluate and investigate the complaints.

Who is this allegation about?

Recipient

Vendor/Contractor

Please select one:

Select if you wish to remain confidential.

Select here to allow your name to be included in the complaint.

Select here if you want to remain anonymous. Your email address will not be available to OIG.

I understand that an anonymous complaint may limit OIG’s ability to conduct an investigation particularly if questions come up that only I can answer. (required)

I also understand that information provided anonymously may be referred to another agency if the OIG determines that action by another agency is warranted. (required)

Affected Program

Child Care

Supplemental Nutrition Assistance Program (SNAP)/Food Stamps

Temporary Assistance for Needy Families (TANF)

Other…

What is the contractor/vendor’s licensed name?

Who is the contractor/vendor’s point of contact?

What agency is the contract with?

Monetary Loss Estimate?

Contractor/vendor's site address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Person's Name

First

Middle

Last

This Person's Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Incident date

Reporter's name

First (required)

Middle

Last (required)

Employee ID

Division/Office (required)

Supervisor

Please explain the fraud, waste or abuse you wish to report. (required)

By clicking submit you attest, the information is true, accurate and complete to the best of your knowledge and understanding, that the falsification, omission or concealment of material fact may be subject to administrative, civil or criminal liability based upon federal and state law.

DHS OIG Fraud, Waste, and Abuse Reporting Form

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