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Request to Report Possible UI Fraud Violations

Help us do as thorough an investigation as possible - provide as much information as you can. Please use the "Additional Information" box if more space is needed. When you are finished, click the "Submit" button located at the bottom of this page.
Person you are reporting.
This Person Should Be Investigated for the Following Reason(s): Check all of the items below that apply and then fill in as much information as you can.
Additional Information
Your Information
You may remain anonymous even if you provide your name and telephone number. This information will be available to the investigator only and will not be part of the file. It is helpful to the investigation if you can be reached for questions.
Yes No
Please correct the following item(s)