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Report Child Care Fraud Form

Your name, phone and email

Providing your name, phone number and email address are optional, but very helpful. Your personal information will remain confidential. To remain anonymous, do not provide this information.

Name:

Phone Number:

Email Address:

Please provide any known information on the fraudulent case below

To be sure we are able to adequately investigate your allegation, be sure to include as much of the following information as possible. If you do not know the answer, don't worry, just tell us what you do know.

First Name:

Last Name:

Business Name:

Tax ID:

Address Line 1:

Address Line 2:

City:

State:

Zip Code:

County:

Phone Number:

Tell us what you know:

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