Report Waste, Fraud, or Abuse Form
Please fill in the following optional information about yourself
Name:
(Optional)
Last Name:
, 		MI:
 First Name:
Address:
(Optional)
Street Number & Name:
City
State:
 Zip:
Phones & Email:
(Optional)
Home Phone:
Cell Phone:
Work Phone:
- ext
(xxx-xxx-xxxx) (xxx-xxx-xxxx) (xxx-xxx-xxxx)
Email:
Relationship to Wayne County:
(Optional)
Other Relation to Wayne County:
Report Information
Report/Complaint:
(Required) 		Description of Report/Allegations/Statement of Facts:
Department
(Optional)
Do you know to which department of Wayne County this report relates to?
  • Did you observe the violations? YES   No
    (Optional)

  • Are there witnesses of violations? YES   No
    (Optional)

  • Did you report these violations before? YES   No
    (Optional)

  • Have you reported these violations to another agency? YES   No
    Name of this agency:
    (Optional)

  • Are you willing to be interviewed by the Inspector General? YES   No
    (Optional)

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