Job & Family Services Office of Unemployment Insurance Operations
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Information about the person committing unemployment compensation fraud:
    *First Name:  
*Last Name:  
Zip Code:  
 Birthdate:     [None] Select a Date Delete the Date
*Briefly Explain How They Are Committing Fraud:    
 When Did Alleged Fraud Start?:     [None] Select a Date Delete the Date
If they are working what is their employer's name, address, and phone number?
    Employer Name:  
Employer Address:     
Employer City:   
Employer State:   
Employer Zip Code:  
 Employer Phone:   
What is your name, address, telephone number, and email address (optional)?
    Your First Name:  
    Your Last Name:  
Your Address:     
Your City:   
Your State:   
Your Zip Code:  
 Your Phone Number:   
 Your Email Address:  

We will review the necessary files and records in light of the information you have provided to determine the most appropriate action. If you provided information about yourself, you will be contacted again only if it is necessary to complete our investigation.