Alleged Misconduct |
| Who committed the alleged misconduct/wrongdoing? (What is the title/position held by the alleged wrongdoer? Please include names, addresses and telephone numbers of victims and witnesses. If providing information concerning contractor or grantee fraud, please provide the name of the primary contractor or sub, type of contract, contract or grant numbers, the date of the award and name of agency official.) |
|
| What exactly did the individual(s) do that was wrong? (Please provide specific and relevant details concerning the alleged misconduct/wrongdoing.) |
|
| When did the misconduct/wrongdoing occur? (Please provide dates and times, if possible.) |
|
| Where did the misconduct/wrongdoing occur? (Please provide the bureau or office, city and state.) |
|
| How was the misconduct/wrongdoing committed? (i.e. falsifying documents, etc.) |
|
| Do you have first hand knowledge of the misconduct/wrongdoing? |
|
| Where can we obtain additional information concerning this misconduct/wrongdoing? (i.e. documents, etc.) |
|
| Who else might be aware of this misconduct/wrongdoing? (Please provide names, addresses and telephone numbers) How would this individual know about this? |
|