EOHLC

Fraud, Waste and Abuse Form

All tips are anonymous unless you provide your name and contact information.

Description of Misconduct

What type of Fraud, Abuse, or Waste are you reporting?(Required)

Please thoroughly describe the event or situation. Detailed, complete and accurate information will improve EOHLC’s ability to respond to your allegationled

Describe the person or entity you are reporting

Please identify the primary person or entity who engaged in the alleged misconduct(Required)

Company or organization of the primary person who engaged in the misconduct, if applicable

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone

Email Address (if known)

Additional individuals involved in the alleged misconduct (if applicable).

Whistleblower Protection

Please explain:(Required)

Yes

I Don't Know

Please explain:

Contact Preference

If you choose to remain anonymous, it is not necessary to fill out the contact information. However, please keep in mind that your decision to elect anonymity may limit our ability to conduct an inquiry, if one is warranted, or to appropriately address your issue. For example, if you choose to remain anonymous, we will not be able to follow-up with you if we need additional information or have questions about the details of your complaint. In some cases, if we do not have sufficient information, we may be unable to act on your complaint. As a result, the more information you can provide, the better chance we have of addressing any wrongdoing that has been committed. You can always request that your identity and/or contact information remain confidential and not be shared outside of EOHLC. Please consider providing your name and/or contact information to allow for follow-up contact by this office.

Please choose one of the following three options(Required)

If necessary, you may contact me for additional information and I do not place any restrictions on the release of my contact information.

If necessary, you may contact me for additional information, but please keep my name confidential and do not share it outside of the Executive Office of Housing and Livable Communities unless required to do so by law such as a court order or subpoena

I wish to remain anonymous.