Kansas Department of Labor

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Unemployment Contact Center

Kansas City: (913) 596-3500
Topeka: (785) 575-1460
Wichita: (316) 383-9947
Toll-Free: (800) 292-6333

KDOL Social Media Policy

Unemployment Fraud Reporting Form

If you believe someone is fraudulently collecting unemployment benefits, please report it immediately to our Fraud Investigations Unit. All allegations of fraud are investigated. Be sure to include as much of the following information as possible so that we can adequately investigate your claim. If you do not know the answer, don’t worry; just tell us what you know. We thank you for your assistance.

Your Contact Information

You can make an anonymous report, but providing us with your contact information allows us to obtain additional information if necessary. Items with aare required.

Do you wish to remain anonymous? Required

YesNo

Your name:

Your phone number with area code: e.g. 555-555-5123 ext 456

Your e-mail address:

Can an investigator contact you for more information, if needed?YesNo

Information about the individual suspected of committing fraud

Please provide as much information as possible.

Full name of the person suspected of
committing fraud: Required

Other names used (Nicknames, etc.):

Last four digits of Social Security Number, if known:

Date of birth:

Address:

City, State, & ZIP:

The person's phone number with area code: e.g. 555-555-5123 ext 456

What leads you to believe this person is committing fraud? Required

Please include all evidence to support this and be as specific as possible:

How did you become aware of this?

Is this person currently employed?YesNoI Don't Know

If yes, please provide the name, address and phone number of the employer.

Employer's name:

Address:

City, State, & ZIP:

Is this person related to the employer?YesNoI Don't Know

What is the name of the owner of the company?

What type of work does or did the person do?

Does this person work full time?YesNoI Don't Know

Did this person start his or her own business?YesNo

If yes, please provide as much information about the business:

type of business,
name, address, and phone number of the business,
advertising information (business cards, newspaper ads, flyers, posters, etc.),
name(s) of customer(s) who used this business and their address(es) and phone number(s),
and, any other information we may use to prove the business exists.

Who else can be contacted to confirm this information?

Name:

Phone number with area code: e.g. 555-555-5123 ext 456

Any other information that you feel will help with this investigation: