Fraud, Waste & Abuse Form

Fraud, Waste & Abuse Form

You can use this online form to report allegations of fraud, waste, and abuse concerning the Arkansas HAF Program.

Person/Business Reporting Fraud

Would you like to remain anonymous?*

If provided, we will have the ability to contact you if we need additional information about your complaint. Your name and information will remain confidential and will not be shared outside of the HAF Program.

Select

Full Name

Phone Number

Email Address

Street Address

City

Zip Code

Person/Business Committing Fraud

Full Name*

If you are reporting more than one individual, please add this information in the Summary Section below.

Phone Number

Email Address

Street Address

City

Zip Code

HAF Application Number (if available)

Event Summary

Summary*

Please furnish the facts of the alleged fraud. Include who, what, when, where, how and why.

File Upload

If you have any external files that may be used as supporting documents in an investigation please upload them below.

Drag and drop files here or

Send me a copy of my responses

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