E-Gov Services City of Farmington

Fraud, Waste, and Abuse Form

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Purpose You can use this online form to report allegations of fraud, waste, and abuse concerning City of Farmington programs and operations.

ALLEGATION
Please provide as much information as possible. Detailed, complete and accurate information will improve the City's ability to respond to your allegation. If you do not know the answer to a question, you can leave the space blank.

* Information is required.

* WHAT
Provide details of the alleged fraud, waste, abuse or mismanagement. Examples of facts and circumstances to include are (1) a description of the misconduct; (2) how you know about the allegation; (3) how and when the misconduct was discovered; (4) the amount of money or assets (equipment) involved; (5) how long the alleged misconduct occurred; (6) attempts by the alleged violator(s) to hide the misconduct; and (7) any other information you believe may be relevant.

* WHEN
When did the misconduct occur? If the misconduct occurred over time or is currently ongoing, enter the actual or approximate start date.

When (date) mm/dd/yyyy

* When (time) hh:mm

* WHERE
Where did the misconduct occur? Add as much detailed information as possible.

WHO
Identify the primary person or department that engaged in the alleged misconduct. If more than one person is involved, enter the additional identifying information in the open box below.

First Name

Last Name

Department

Company/Organization

Additional individuals involved in the alleged misconduct

OTHER
Please provide any additional information concerning this misconduct, such as (1) a list of description of any documents or other evidence you or others may have that is relevant to the complaint; (2) the names and contact information for other witnesses who could provide additional information; and (3) any other information that you believe may be relevant to the complaint.

* SUBMITTED BY (To remain confidential until further notice. For response and additional inquiry purposes only.)

Name

* E-mail

Attach a Picture or File (max size: 30MB):

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* Information is required.

Notes:

If you send us a message, you will receive a Tracking Number allowing you to follow-up with your request, at your convenience.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.