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Welfare Fraud Complaint Form
This form has been modified since it was saved. Please review all fields before submitting.
Your First Name
Your Last Name
Your Phone Number
Name of the person you are reporting
First and Last Name
Address of the person you are reporting
Address Line 2
Names and ages of other people living with the person you are reporting.
(significant other, children, other relatives, etc.)
Do you know the age or date of birth of the person you are reporting?
Do you know the Social Security Number of the person you are reporting?
Does the person you are reporting work? If so, do you know where?
Please tell us why you think they are committing Welfare Fraud:
Any additional comments?
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