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To report suspected Fraud, Waste and/or Abuse, please complete the information requested below.

Please be as specific as possible about the dates and details that will help support your allegation(s).

You can submit an anonymous complaint to report Fraud, Waste and/or Abuse to the Special Investigation Unit, or you may make a report of possible unethical or improper actions through our third-party vendor, EthicsPoint. Please submit separate entries for each suspect.

Only items marked with an asterisk (*) are required.

Person or Company Suspected of Committing the Fraud or Abuse

Victim(s) (if other than Yourself)

Complainant (Yourself)

Have you attempted to contact the person(s) suspected of committing the fraud/abuse concerning your complaint?


Please list all individuals who may have knowledge concerning the activity that may be fraudulent or abusive. If you need to list additional witnesses, please do so in the comments section of this report. Please give full name, address and phone number(s).

Describe the Fraud/Abuse

Please provide as much information as possible concerning your complaint. Be sure to include all details such as dates,times, where it took place, etc.

FB FRD 002 NF 102022