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 a * are required.
* Yes
No
  e.g. 555-555-5123 ext 456
Yes
No

Information about the individual suspected of committing fraud

Please provide as much information as possible.
*

  e.g. 555-555-5123 ext 456
*
Yes
No
I Don't Know
If yes, please provide the name, address and phone number of the employer.

Yes
No
I Don't Know
Yes
No
I Don't Know
Yes
No
If yes, please provide as much information about the business as you can:
  • 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 contaced to confirm this information?

  e.g. 555-555-5123 ext 456