Government Fraud Complaint Form

The Office of State Inspector General works to maintain public confidence in government by combating fraud, waste, misconduct, and abuse in Commonwealth programs, operations, and contracts.

Complaints can be against a person and/or an agency/business. Please provide as much of the following information as possible. The more information you provide, the more thorough an investigation can be.

REPORTING UNEMPLOYMENT COMPENSATION (UC) FRAUD? STOP!

The below form is not designed for UC fraud, but you may go here or call 1-800-692-7469 to report UC fraud.

*** All fields with a red asterisk (*) must be completed for the complaint to be processed.

Please correct the following errors:

First Name: Middle Name or Initial: Last Name: Nickname(s): Other Name(s): Address: City: State: Zip Code (5 digits): Date of Birth: Approximate Age (if DOB unknown): Driver's License Number: Issuing State of Driver's License: Vehicle Description (Make, Model, Year, Color): Others Involved: Employer: Position Title: Employer Street Address: Employer City: Employer State: Employer Zip Code (5 digits): Business Name: Business Owner: Business Address: Business City: Business State: Business Zip Code (5 digits): Business Telephone (format: 555-555-5555): Business Hours of Operation: Explain the Complaint: Date Violation was Observed: Time Violation was Observed (Eastern Time):

The following information is optional. You may choose to remain anonymous, however, entering your contact information below allows the OIG to contact you in the event additional information is required regarding your tip.

Your Name: Your Address: Your City: Your State: Your Zip Code (5 digits): Your Telephone Number (format: 555-555-5555): Your Email: