East Dunbartonshire Council - Report benefit fraud

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BENEFIT FRAUD REFERRAL FORM You are not required to complete all sections of this form but the more details you can supply the more likely any subsequent investigation will result in a positive outcome.
Section A: Who do you think is committing Benefit Fraud?
Person Details
Their Title
Their Fullname
Nicknames or other names used
Gender
Address
Telephone number
Date of birth (if known)
National Insurance Number (if known)
type of fraud do you think is being committed? (Please select from the drop down list opposite).
What benefits do you think are being claimed wrongly? (Please select from the drop down list opposite).
Are there other benefits involved?
Tell us more about the circumstances here. For example, why do you think fraud is being committed?
Section B: Tell us more about the person you suspect is committing fraud
Appearance
Tell us about the person's appearance.
A: Age (approximate within 4 years ie 20-24)
B: Build (qualify by example if possible)
C: Clothing (uniforms, brands, logos etc)
D: Distinguishing marks (tattoos, scars, complexion)
E: Elevation/height (approx within 4
F: Face (complexion, facial hair, glasses, jewellery)
G: Gait (how they walk)
H: Hair (style, colour, length etc)
Vehicle Details
Tell us about the person's vehicle (if they have one).
S: Shape (saloon, estate, mpv etc)
C: Colour (basic, metallic)
R: Registration (full/part)
I: Identifying marks (dents, alloy wheels, lights etc)
M: Make and model
Employment Details
Tell us about the person's employment.
Their employer's name
Their employer's address
What days does the person work?	Monday Tuesday Wednesday Thursday Friday Saturday Sunday
What hours does the person work?	AM PM Not Known
How much do they earn (per week/month)?
Do you think the employer knows the person is claiming?	Yes No
Section C: Does the person have a partner?
Does the person you think is committing fraud have a partner?	Yes No
Partner's Details
If yes, tell us about the partner:
Partner title
Partner full name
Partner Nicknames or other names used
Partner gender	Male Female
Partner Address
Partner Telephone Number
Partner Date of birth or age (if known)
Partner National Insurance number (if known)
What type of fraud do you think they are committing? (Please select from the drop down list opposite).
What benefits do you think are being claimed wrongly? (Please select from the drop down list opposite).
Are there other benefits involved?
Tell us more about the circumstances here. For example, why do you think fraud is being committed?
Partner's Appearance
Use this space to tell us about the person's appearance eg their build, eye colour, clothing, distinguishing features.
A: Age (approximate within 4 years ie 20-24)
B: Build (qualify by example if possible)
C: Clothing (uniforms, brands, logos etc)
D: Distinguishing marks (tattoos, scars, complexion)
E: Elevation/height (approx within 4")
F: Face (complexion, facial hair, glasses, jewellery)
G: Gait (how they walk)
H: Hair (style, colour, length etc)
Partner's Vehicle
Tell us about the person's vehicle (if they have one).
S: Shape (saloon, estate, mpv etc)
C: Colour (basic, metallic)
R: Registration (full/part)
I: Identifying marks (dents, alloy wheels, lights etc)
M: Make and model
Partner's Employment
Tell us about the person's employment.
Their employer's name
Their employer's address
What days does the person's partner work?	Monday Tuesday Wednesday Thursday Friday Saturday Sunday
What hours does the person work?	AM PM Not Known
How much do they earn (per week/month)?
Please use this space to tell us anything else we may need to know.
Do you think the employer knows the person is claiming benefit?	Yes No Don't know
Section D: Your Details
Your Details
This section is optional - you do not have to fill it in. It may help us however, if we need to contact you to clarify any details. We will treat your details in confidence and not pass any information onto anyone else.
Title
Name
Address
Telephone Number
Email Address

The information provided on this form will be processed by East Dunbartonshire Council in accordance with the Data Protection Act 1998. Your personal data will be used only for responding to your enquiry and for statistical purposes.