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Contractor Disclosure Form

The Federal Acquisition Regulation (FAR) now requires all contractors to notify the government whenever they become aware of a contract overpayment or fraud. If you are a federal contractor, or employee of same, and you have evidence of a violation of Federal law involving fraud, conflict of interest, bribery, gratuity violations, or violations of the False Claims Act, please complete and submit this form.

SECTION A: Your Information
SECTION B: Who are you reporting
WHEN DID THIS OCCUR?
WITNESS 1
WITNESS 2
SECTION C: DISCLOSURE INFORMATION
Has an investigation been conducted?
Full Description:
SECTION D: CERTIFICATION AND CONFIRMATION

By clicking the "submit" button below, I certify under penalty of perjury that the information contained herein is true and correct to the best of my knowledge as of the date of this submission.

After clicking the “submit” button below, you will be provided with a “confirmation number” in reference to this disclosure submission.

CAPTCHA
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Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
If you are submitting a report of fraud, waste, abuse, and/or mismanagement to OIG Hotline and have additional documentation to support the allegation please retain the information but annotate in the narrative that you have additional information. If it is determined that the additional information is needed, a HUD OIG employee will be in contact with you to facilitate the transfer of that information.