Fraud

If you suspect someone of fraud, please complete as much of this form as you can.

If you don't know the answers to some of the questions don't worry. All the information you provide will be strictly confidential and although you do not have to give us your name and address you can voluntarily do so.

Please make sure that you are not being watched while you are filling in this form to keep the information you give as confidential as possible. If you print out a copy of the completed form, you should also keep this safe.

Required fields are marked with an asterisk (*).

Jump to section:

• Section 1 - About the person you suspect of committing fraud
• Section 2 - About the partner of the person you suspect
• Section 3 - About you
• Section 4 - Other details

1a. What type of fraud is being committed?

Type of fraud *

-- Please select one --Business RatesCouncil TaxClaiming to be living alone; partner not declaredMore than one claim for benefitNot telling us about savingsNot living at addressNot telling us about earningsWorking and fraudulently claiming benefitCashing someone else's girocheque/order bookOther (Please specify below)

Details about the fraud being committed *

What makes you think fraud is being committed? *

1b. Who do you suspect of fraud?

Title

-- Select one --MrMsMrsMissDrProf

First name *

Last name *

House name/ number *

Street name *

Town

County

Postcode *

Country

AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoDemocratic Republic of the CongoCook IslandsCosta RicaCôte d'Ivoire (Ivory Coast)CroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoFormer Yugoslav Republic of MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoFederated States of MicronesiaRepublic of MoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTimor-Leste (East Timor)TogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaViet NamBritish Virgin IslandsU.S. Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabwe

National Insurance No (if known)

Their gender *

-- Please select one --MaleFemale

Their date of birth

Day 12345678910111213141516171819202122232425262728293031 Month JanFebMarAprMayJunJulAugSepOctNovDec Year 19001901190219031904190519061907190819091910191119121913191419151916191719181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072207320742075207620772078207920802081208220832084208520862087208820892090209120922093209420952096209720982099

Type of fraud involved *

-- Please select one --Council Tax BenefitCouncil Tax Reduction SchemeDisability Living AllowanceHousing BenefitIncapacity BenefitIncome SupportJobseeker's AllowanceOther

If other, please give details

1c. Appearance of person committing fraud

Their ethnic group

• White
• Black
• Asian
• Chinese
• Other (please specify below)

If other ethnic, please specify

Their build (Ctrl+Click selects multiple values)

-- Select one or more --BroadHeavyMediumOverweightProportionateShortSlimSmallStockyTallThinOther

If other build, please specify

Their eye colour

-- Select one --BlackBlueBrownGreenGreyHazelPinkUnknown

Eyewear *

-- Select one --GlassesContact LensesNeitherNot sure

Hair colour *

-- Select one --AuburnBlackBlueBlondeBrownDark BrownFairGingerGreenGreyHighlightedLight BrownMouseyMulti-ColouredOrangePinkPurpleRedSandyStreakedWhiteYellowOther

Hair type * Ctrl+Click selects multiple values

-- Select one or more --AfroBouffantBaldCurlyDirtyDreadlocksGreasyLongMohicanPermedPlaitedPonytailPunkQuiffedShavenShortSkinheadSpikeySpikedStraightThinningTidyUntidyWavyWig

If other hair colour, specify here

Distinguishing features E.g. facial hair, tattoos, scars, piercings

Other information about their appearance Style of clothing e.g. always wears jeans, wears distinctive jewellery

1d. Their employment

Their employer knows *

-- Select one --Don't knowYesNo

Their employer's name

Their employer's address If you know it

Other details about their work E.g. type of work, times, days they work, dress, how much they earn etc.

1e. Their vehicle details

Make and model

Registration no

Colour

Other features Any other distinguishing details or features

1f. Does the person you suspect have a partner?

Does the person have a partner? *

• Yes - go to section 2
• No - go to section 3
• Don't know - go to section 3

Jump to section:

• Section 1 - About the person you suspect of committing fraud
• Section 2 - About the partner of the person you suspect
• Section 3 - About you
• Section 4 - Other details

2a. What type of fraud is being committed?

Type of benefit fraud *

-- Select one --Cashing someone else's girocheque/order bookLiving with a partner while claiming to be living aloneMore than one claim for benefitNot telling us about savingsNot living at addressNot telling us about earningsWorking and fraudulently claiming benefitOther (Please specify below)

Any other information Please give details about the type of benefit fraud being committed e.g. if living together when did this start? If the couple have children please give full details of names, sex age and so on

What makes you think fraud is being committed? *

2b. Partner Details

Title *

-- Select one --MrMsMrsMissDrProf

First name

Last name

House name/ number

Street name

Town

County

Postcode

Country

AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoDemocratic Republic of the CongoCook IslandsCosta RicaCôte d'Ivoire (Ivory Coast)CroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoFormer Yugoslav Republic of MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoFederated States of MicronesiaRepublic of MoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTimor-Leste (East Timor)TogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaViet NamBritish Virgin IslandsU.S. Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabwe

National Insurance No (if known)

Their gender *

-- Select one --MaleFemale

Their date of birth

Day 12345678910111213141516171819202122232425262728293031 Month JanFebMarAprMayJunJulAugSepOctNovDec Year 19001901190219031904190519061907190819091910191119121913191419151916191719181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072207320742075207620772078207920802081208220832084208520862087208820892090209120922093209420952096209720982099

Type of fraud involved *

-- Select one --Council Tax BenefitCouncil Tax Reduction SchemeDisability Living AllowanceHousing BenefitIncapacity BenefitIncome SupportJobseeker's AllowanceOther

If other, please give details

2c. Appearance of partner

Their ethnic group

• White
• Black
• Asian
• Chinese
• Other (please specify below)

If other ethnic, please specify

Their build * (Ctrl+Click selects multiple values)

-- Select one or more --BroadHeavyMediumOverweightProportionateShortSlimSmallStockyTallThinOther

If other build, please specify

Their eye colour *

-- Select one --BlackBlueBrownGreenGreyHazelPinkUnknown

Eyewear *

-- Select one --GlassesContact lensesNeitherNot sure

Hair colour *

-- Select one --AuburnBlackBlueBlondeBrownDark BrownFairGingerGreenGreyHighlightedLight BrownMouseyMulti-ColouredOrangePinkPurpleRedSandyStreakedWhiteYellowOther

Hair type * Ctrl+Click selects multiple values

-- Select one or more --AfroBouffantBaldCurlyDirtyDreadlocksGreasyLongMohicanPermedPlaitedPonytailPunkQuiffedShavenShortSkinheadSpikeySpikedStraightThinningTidyUntidyWavyWig

If other hair colour, specify here

Distinguishing features E.g. facial hair, tattoos, scars, piercings

Other information about their appearance Style of clothing e.g. always wears jeans, wears distinctive jewellery

2d. Partner's employment

Their employer knows *

-- Select one --Don't knowYesNo

Their employer's name

Their employer's address If you know it

Other details about their work E.g. type of work, times, days they work, dress, how much they earn etc.

2e. Partner's vehicle details

Make and model

Registration no

Colour

Other features Any other distinguishing details or features

Jump to section:

• Section 1 - About the person you suspect of committing fraud
• Section 2 - About the partner of the person you suspect
• Section 3 - About you
• Section 4 - Other details

Section 3 - About you

Title

-- Please Select --MrMsMrsMissDrProf

First name *

Last name *

House name/ number *

Street name *

Town

County

Postcode *

Country

AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoDemocratic Republic of the CongoCook IslandsCosta RicaCôte d'Ivoire (Ivory Coast)CroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoFormer Yugoslav Republic of MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoFederated States of MicronesiaRepublic of MoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTimor-Leste (East Timor)TogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaViet NamBritish Virgin IslandsU.S. Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabwe

Contact options

If you wish us to keep you informed about the progress, select how we can contact you

• Daytime phone
• Evening phone
• By email

Contact time Ctrl+Click to select multiple

-- Select one or more --DaytimeEvening

Daytime phone Numbers only (no spaces, hyphens etc.)

Evening phone Numbers only (no spaces, hyphens etc.)

Email address

Jump to section:

• Section 1 - About the person you suspect of committing fraud
• Section 2 - About the partner of the person you suspect
• Section 3 - About you
• Section 4 - Other details

Section 4 - Other details

Is there anything else we should know?

Prevention and Detection of Fraud

This council is under a duty to protect the public funds it administers and to this end may use the information you have provided on this form for the prevention and detection of fraud. It may also share this information with other bodies responsible for auditing or administering public funds for these purposes. Further information.