Please provide the name and address of the individual(s) who are alleged to have committed fraud:
Please provide the specific events and evidence, or loss to HUD program. Include any scheme you believe was used to perpetrate the alleged fraud:
[Include any documentation to support the allegation(s). Information that is too vague or cannot be supported can result in a closed report with no action taken.]
Please provide the date (include time and frequency if possible) of the specific event(s):
Your name and contact information is completely voluntary – it’s not required to make a report. However, it may be beneficial to do so in case the PHA has additional questions.