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2. Directions
   Please fill out the form below and the information will be sent to the County Auditor's Office for review. Once the form is submitted, the County Auditor or his designee will review your report and decide how best to proceed. While providing contact information is not required, it can be beneficial if the County Auditor requires additional information to perform a review. The County Auditor will protect your identity as required by office policies.
4. County Department / Office Involved:
6. Detailed description of fraud / abuse:
   Please provide as much information as you can, including date, time and location of incident if available.
8. Are you a county employee?

   1. Yes
   2. No

   Optional
9. May we contact you for more information if necessary?

   1. Yes
   2. No

   If yes, please provide contact information below.
11. Name
    Optional
13. Email
    Optional
15. Phone Number
    Optional
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17. 1. Receive an email copy of this form.
18. Email address

    This field is not part of the form submission.

19. Submit

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