Report Welfare Recipient Fraud

The purpose of this form is to provide another avenue for the public to report welfare fraud complaints. A complaint should only be completed if the client has applied for and/or has been issued benefits that they were not entitled to. To ensure that your complaint is investigated thoroughly, please complete this form and provide as much information as possible.

A complaint may also be made by calling the Department of Human Services and selecting the Welfare Fraud hotline option at 1-800-332-6347.

All fields with a red asterisk must be filled out

Name of Person who has violated * First Last
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Date of Birth / MM / DD YYYY
Age
Allegation *
Name of Complainant First Last
Complainant's Contact Information

(However, you may remain anonymous)
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