ILLINOIS AUDITOR GENERAL'S OFFICE
FRAUD REPORTING FORM

You may submit your allegation without revealing your name or identifying information. Your allegation may be referred to another agency, including the agency that is the subject of your allegation or a law enforcement or investigatory agency. If you choose to identify yourself, your identity is not confidential and may be revealed. Further, there are inherent limitations in internet security and information you choose to submit via the world wide web may not be protected from disclosure during transmission. By clicking the "I Accept" button below, you are acknowledging that any information you provide may be subject to further disclosure and referral.


 

Optional Information About Yourself:

Name:

Street Address, City, State, Zip Code:

Telephone Number:

E-mail Address:

Confirm E-mail Address:

What is the best way for us to contact you if we need to? (Please give specific time, method and number.)

Information about your Allegation:

1. To the best of your knowledge, does your allegation involve a State agency in the Executive Branch (for an explanation, see paragraph (b) of "How to Report Fraud Allegations to the Auditor General's Office)?

Yes No

If your answer is "yes," please proceed to the next question

If your answer is "no," the Auditor General's Office does not have the authority to handle your complaint. Call us or click on "Find Help with Your Complaint" for guidance in contacting the appropriate agency for assistance with your complaint.

2. What executive branch State agency is involved in your allegation?


3. Does your allegation involve an entity doing business with a State agency, such as a contractor or
grant recipient?  Yes No

If yes, please provide any identifying information you have (name, address, etc.) regarding the contractor or grant recipient:

4. Describe the fraud. Please provide as much detail as possible, including name, employing agency and title of person involved, date of occurrence, amount of money involved (if applicable), etc.

4. Describe the fraud. Please provide as much detail as possible, including name, employing agency and title of person involved, date of occurrence, amount of money involved (if applicable), etc.

5. Do you have any information or evidence to provide supporting your allegation?

a. Name and contact information for any witnesses:

b. Documentation (invoices, vouchers, receipts). Describe (e.g., invoice number, date and amount) and provide copies.*

*Copies may be scanned and sent by e-mail or U.S. Postal Service to the address given in the Instructions.

6. Has your allegation been reported to any other entity?
   Yes No

If yes, please provide name of entity, date filed, tracking number (if available) and status or outcome (if known).

7. Has your allegation been the subject of any grievance proceeding?
   Yes No

If yes, please provide name of entity, date filed, tracking number (if available) and status or outcome (if known).

8. If there is any other information useful to our review of your allegation that has not already been requested, please provide it below.

Submitting your Allegation:

By clicking on the "Submit Allegation" button below, you are acknowledging that, to the best of your knowledge, the information you are providing is accurate.