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Internal Audit
County of Orange - Fraud Reporting Form


Please mail any documentation that may support the alleged fraud to:

OC Fraud Hotline
12 Civic Center Drive RM 232
Santa Ana, 92701

Contact Information
Please add your name to the contact information; however if you wish, you can remain anonymous
Name:
Job Title:
Department/Agency:
Home Telephone:
Work Telephone:
Email Address :
 
Alleged Participant(s)
Please state the name of the individual(s) you feel are commiting fraud.
Name:
Job Title :
Agency:
Department:
Status: Current Employee    Past Employee    Vendor    Contractor 
Other:
Please add more names if applicable.
Name:
Job Title :
Agency:
Department:
Status: Current Employee    Past Employee    Vendor    Contractor 
Other:
   
Name:
Job Title :
Agency:
Department:
Status: Current Employee    Past Employee    Vendor    Contractor 
Status Other:
 
Incident
Theft:  
Cash:
Equipment:
Supplies:
Other:
Payroll Related:  
Overpayment:
Fictitious Employee:
Overtime:
Time Abuse:
Misuse of County Resources:  
Vehicles:
Telephones:
Computers:
Other:
   
How may occurances?:
 If more than one incedent type number of Instances:
 
Location Information

Please tell us as much information and detail regarding the suspected fraud. Who, what, when & where, and how much, if applicable.

   
Date and Time :
 

 

Description of Incident:


Please include as much information as possible

 

 

Additional Comments::

 

 
 
400 W. Civic Center Drive Room 232, Santa Ana, California 92701-4521
714.834.5475 main line – 714.834.2880 fax
 
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