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Report Fraud
Report Fraud
Overview
Subject
Your Information
I wish to remain anonymous
Please provide your phone number or email address in case we need more information.
Complaint Type
BPAI
IHSS
First Name
Last Name
Email Address
Relationship
Family Member
Friend
Neighbor
Gov Agency
Other Agency
Telephone Number
Cell Phone Number
Street 1
Street 2
Street 3
City
State
California
Alabama
Alaska
Arizona
Arkansas
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississipii
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Agency
Adult Protective Services
AIS Call Center
AIS Case Management
BPAI Call Center
Child Care
CWS
DCSS
DHCS
Eligibility
Housing
IHSS
Probation
Public Authority
Other Agency
Agency ID
Person You Are Reporting
First Name
Last Name
Street 1
Street 2
Street 3
City
State
California
Alabama
Alaska
Arizona
Arkansas
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississipii
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Recipient Zip Code
Date of Birth
Approximate Age
Social Security Number
Driver's License Number
Client ID Number
List Any Children Involved
Additional Persons or Organizations Involved
Programs (if known)
Examples of programs we investigate are CalWORKs, CalFresh, CAPI, General Assistance, and IHSS.
Suspected Fraud Details
What is the Suspected Fraud?
Falsifying household composition and size
Purposely not reporting income and/or employment status
Residing outside the State of California
Other (describe)
Suspected Fraud Description
Other
Has this complaint already been submitted elsewhere?
Has this complaint already been submitted elsewhere?
No
Has this complaint already been submitted elsewhere?
Yes
If yes, to what person or agency? (Describe)
Attachments
Please provide a description of the attachments.
Attach a file