Report Fraud

Using the form below - Please enter the information about the person you suspect is committing Cash Assistance fraud.

Report Cash Assistance Fraud

This web page is a secure document. Any information you see or enter is encrypted for privacy during transmission and will not be easily read by a third party.

* Denotes Required Field

First Name: *

Last Name: *

Address:

City:

State:

Zip Code:

Birthdate:

Briefly explain how you know they are committing fraud: *

When Did Alleged Fraud Start?

If they are working, please provide as many details as you can about their employer:

Employer Name:

Employer Address:

Employer City:

Employer State:

Zip Code:

Employer Phone:

What is your name, address, telephone number, and email address?

Your First Name:

Your Last Name:

Your Address:

Your City:

Your State:

Your Zip Code:

Your Phone Number:

Your Email Address:

Is this an emergency?

Yes  

No  



Security Measure