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Complaint Form

Office of the Inspector General
P.O. Box 208
Trenton, NJ 08625-02085


Fax Number: 609-984-3990

Please fill in the information below. Initially, you will receive confirmation that the Office of the Inspector General has received your complaint form. Our investigators will review the complaint to determine if it falls within our jurisdiction. You will be notified if an investigation is appropriate or if your complaint should be referred to another state agency.

Technical Note: If you are unable to use this form or wish to send us a complaint by mail or fax, you may do so by using this Complaint form. (43 kb) Requires Adobe Acrobat Reader  

**Please note that you may remain anonymous when submitting this form however, if you would like to be contacted please submit your Contact Information.


Electronic Complaint Form to
Office of the Inspector General
 

Contact Information
(Information in this section is not required unless you wish to be contacted)
Name  

Prefix:

 

First Name:

MI:

Last Name:

 
Address

Street:

Suite/P.O.Box:

City:

County:

(required in NJ only)

State:

(required in US only)

Zip Code:

-

Country:

Phone Number: 

- - Ext:

E-mail:

Complaint Information

Is your complaint against a State of New Jersey employee(s), agency, or vendor of the State? Please note that the Office of the Inspector General only has the authority to review or investigate complaints with regard to waste, mismanagement, and fraud within entities that receive state funding.

Name  

Prefix:

 

First Name:

MI:

Last Name:

 
Address

Street:

Suite/P.O.Box:

City:

County:

(required in NJ only)

State:

(required in US only)

Zip Code:

-

Country:

Phone Number:

- - Ext:

E-mail:

Web site:

Have you filed the same complaint with any other federal, state or local agency?

If Yes, with what agency did you file a complaint?

Do you have a complaint number, if so please list it:

Has your complaint been resolved?


If yes, briefly summarize the results:



Have you filed a complaint with our office in the past?
Do you have a confirmation number, if so please list it:
Is your current complaint related to the one previosly filed?
May we refer your complaint to the appropriate agency, if necessary?


Summary of your complaint:



List any other person(s) who could be a witness to the complaint you have alleged:
Name:
Contact Info:
Name:
Contact Info:



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