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Welfare Fraud Complaint Form

  1. Disclaimer

    Information submitted on this form will be sent via unsecured email. To protect sensitive information, do not enter the following items or similar information on this form: Social Security numbers, driver’s license numbers, bank account information, routing numbers, credit card numbers, medical information, passport numbers, and passwords. Please review our privacy policy located at By submitting this form, you acknowledge and accept the terms listed in the privacy policy.

  2. Do you wish to remain anonymous?
  3. First and Last Name
  4. (significant other, children, other relatives, etc.)
  5. Do you know the Social Security Number of the person you are reporting?
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      2. This field is not part of the form submission.