OPM Office of the Inspector General

Hotline to Report Fraud, Waste or Abuse

This form is for filing carrier notifications with the Office of Personnel Management Office of the Inspector General.

THIS FORM IS INTENDED FOR REPORTING FRAUD, WASTE, AND ABUSE.

Privacy Act Statement

Pursuant to 5 U.S.C. § 552a(e)(3), this Privacy Act Statement serves to inform you of why OPM is requesting the information on this form.

Authority: The Inspector General Act, 5 U.S.C. App. 3, authorizes the audit, investigation, and evaluation of OPM programs and operations as well as the collection of related information. Executive Order 9397, as amended by Executive Order 13478, permits the collection and use of Social Security Numbers (SSNs).

Purpose: The U.S. Office of Personnel Management (OPM) Office of the Inspector General (OIG) will use this information to conduct law enforcement investigations and activities concerning suspected or potential fraud, waste, abuse, and violations of laws, regulations, and policies related to OPM programs and operations. SSNs are used to confirm individuals’ identities and to facilitate certain law enforcement requests.

Routine Uses: The information requested on this form may be shared with OPM personnel as well as externally as a “routine use” to others outside of OPM, including contractors or other law enforcement personnel who need the information to assist in the investigation of OPM programs and operations. Additionally, information may be shared with other establishments in the executive, legislative, and judicial branches of the Federal Government in order to comply with various reporting requirements. A complete list of the routine uses can be found in the system of records notice associated with this form, OPM\CENTRAL-4.

Consequences of Failure to Provide Information: Providing this information (including your SSN) is voluntary; however, failure to provide the requested information may hinder the OPM OIG from thoroughly reviewing and/or resolving the carrier notification. Anonymous carrier notifications may limit our ability to process your carrier notification as we are not able to contact you for additional information or clarification.

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Carrier Notification Form
Section I
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Section II
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Section III - Documents (Please do not upload claims data)
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Section IV - Notes
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