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Online Benefit Fraud Form

 

Section 1 Who do you suspect is committing the Fraud?
Title
Gender (required)
First Name (required)
Surname (required)
Nickname / aliases
Address (required)		enter your address here
Home Telephone Number (required)
Work Telephone Number
Date of Birth		(DD/MM/YYYY)
Age
National Insurance No.
Section 2 Type of fraudulent activity
When did the fraud start?
Why do you think the claim is fraudulent?
What type of fraud is being committed?
			Not living in property
			Not declaring work
			Not declaring income
			Not declaring savings
			Has partner living with them
			Has non-dependant living with them
			Is living with landlord as a couple
			Is living with a close relative
Other
Section 3 Living arrangements
What address do you think they are actually living at?		enter their address here
Does the Landlord know?		Yes   No   Don't Know
If Yes why do you think so?
Do they intend to come back?
Is the property being sub-let?
If Yes, to who?
Section 4 Employment
How do they get to work?
At what time do they leave home?
When do they work?
From am pm	to am pm		Monday
From am pm	to am pm		Tuesday
From am pm	to am pm		Wednesday
From am pm	to am pm		Thursday
From am pm	to am pm		Friday
From am pm	to am pm		Saturday
From am pm	to am pm		Sunday
Does their employer know that they haven't declared the work?		Yes    No   Don't Know
Does their employer know that they haven't declared the work?		Yes    No   Don't Know
Vehicle details
Car make / model
Car registration
Car Colour
Section 5 Income
What other income haven't they declared?		enter your address here
Where is this from? e.g. trust funds, rent.
Section 6 Capital Investments
What other capital do they have?
How much is this worth?
Where is this capital - Bank, Building Society, second property?
Section 7 Details of partners
First name of partner
Surname of partner:
Date of birth of partner:
Do they work?		Yes   No
If Yes, where do they work?
What hours do they work?
From am pm	to am pm		Monday
From am pm	to am pm		Tuesday
From am pm	to am pm		Wednesday
From am pm	to am pm		Thursday
From am pm	to am pm		Friday
From am pm	to am pm		Saturday
From am pm	to am pm		Sunday
How long has the partner been living there?
Section 8 Other people in the house
First name
Surname
Age
Date of birth		(DD/MM/YYYY)
What is their income?
Section 9 Living as a couple with the landlord
Landlord's first name
Landlord's Family name
How long have they been living as a couple?
Does landlord know about the benefit claim?		Yes   No   Don't Know
Section 10 Landlord is a close relative and is living in the same property
Landlord's first name
Landlord's Family name
What is their relationship?
Does relation know of the benefit claim?		Yes   No   Don't Know
Section 11 Any other information
Please enter below any other information you think may be useful.		enter any other information here
Section 12 The information given above will be treated in strict confidence. You do NOT have to tell us who you are but if you would like one of our officers to contact you for more information please fill in the details below.
Your name
Contact number
Address:		enter your address here

Click on Submit button once you have completed the form.