Report Fraud Form - Pinal County

Report Fraud

Disclaimer - The Fraud Hotline and online reporting form are designed for reporting suspected cases of fraud, waste, or abuse. The Fraud Hotline and online reporting form are not a substitute for employment-related grievances or appeals, as existing County policy and procedures provide channels for resolution of these issues. The following link will take you to the current policy and procedure page for Pinal County employees: Policies and Procedures

Your Information

First Name:

Middle:

Last Name:

Email Address:
Position:
Employer/Department:
Address:
Address Cont.
City:
State:
County:
Zip:
Work Phone:

Subject Information *Required Field

*First Name:

Middle:

*Last Name:

Position:
*Organization:
Emp./Dept. Address:
Address Cont.
City:
State:
County:
Zip:
Work Phone:

Complaint

Briefly describe the improper activity(ies) and how you know about them. Specify who, what, when, where, and how. Number the allegations.

When did the event(s) take place? Please indicate date, time, and frequency, if applicable.

Where did the event(s) occur?

Have you reported this information to another agency?

Which one?

If you have disclosed the information reported here, what is the current status of the matter?

Describe the information you are disclosing here (Click all that apply):

	Abuse of Authority		Substantial and specific danger to the public health or safety
	Gross waste of public funds		Violation of state law or regulation
	Other (Please explain)

Please enter the word you see above

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