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Please provide some information about the person(s), department, agency, entity, contractor or vendor about which you are alleging a violation(s) of waste, fraud, misconduct, mismanagement or other abuse. |
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Have you reported this alleged violation(s) to any other authority?: |
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When reporting fraud, waste, or abuse, you may remain anonymous if you wish. You are encouraged to identify yourself so that we may follow-up on your complaint via e-mail or telephone, and obtain additional information that may be helpful to our review of the matter. Complaints may also be filed as a potential Whistle-blower.
When reporting information to the OIG, please be as specific and provide as much detail as possible. The more information you provide, the better, as it helps determine how we respond to your complaint. Any relevant information or knowledge you acquire after making your report to the OIG should be reported in a follow-up submission. |
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If you have checked this box please skip to the bottom of this form and submit without filling out the contact information below. You may also mail or fax a completed form. |
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In order to be granted whistle-blower status your complaint(s) must rise to the level of “gross” mismanagement, malfeasance, misfeasance, waste of public funds, or neglect of duty committed by an employee or agent of an agency or independent contractor. You must provide your name below in order to be considered for whistle-blower status. |
If you are not requesting to remain anonymous, please provide the following:
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Security Code: |
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