Report Fraud Form

Any agency or entity as defined in La. R.S. 24:513 that receives state or local government funds should use this form to report known or suspected losses of public funds or other illegal activity to the Legislative Auditor’s Office.

Use the form below to report fraud.

While this information is optional, providing us with your name and telephone number will allow us to contact you with any additional questions.

Name

Format: ex: Bob Jones

Phone

Format: ex: (999)-999-9999

Format: ex: bobjones@email.com

What is the name of the entity where the loss or illegal activity occurred?

Parish where loss or illegal activity occured

What type(s) of fraud, waste, or abuse are you reporting? (Check all that apply)

Theft of Public Funds and/or Equipment

Personal use of Public Funds and/or Equipment

Public Official/Employee Doing Business With Himself/Herself

Public Official/Employee Accepting Something of Value (or Kickback) From A Vendor

Public Official/Employee Paying For Work Not Performed by A Vendor

Public Official/Employee Paying Excessive Amounts For Services

Public Official/Employee Falsifying Expense Reimbursements

Public Payroll Fraud

Other fraud, waste or abuse

When did the suspected loss/illegal activity occur?

Format: MM/DD/YYYY

What is the suspected amount of loss, if any?

Format: ex: 200.00

Please describe the suspected loss or activity

Name of the person who allegedly performed the illegal activity

Format: ex: John Doe

Why do you believe the illegal activity occurred?

Are other public employees or private third party parties involved?

Yes

Please include names

Format: eg: Jim Tharp, Lacey Daigle, Bob Magee

How was the suspected loss detected?

Is the suspected loss or illegal activity continuing?

Yes

List the names of the possible witnesses to the suspected loss or illegal activity.

List the names of individuals who would most likely cooperate/help with the investigation

Is an investigation in progress?

Yes

Please list the name of the agency or investigative body

What actions have you taken to date, if any?

Has a police report been filed?

Yes

Has the District Attorney been notified?

Yes

Please attach any evidence or documents that support your allegations.

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