This form is provided as a convenience to allow contractors to comply with the reporting requirements in the December 12, 2008, FAR amendment, 73 Fed. Reg. 67064. Specifically, contractors may use this form to satisfy the requirement that they notify, in writing, the agency (NARA) Office of the Inspector General, whenever the contractor has credible evidence that a principal, employee, agent, or subcontractor of the Contractor has committed a violation of the civil False Claims Act or a violation of Federal criminal law involving fraud, conflict of interest, bribery, or gratuity violations in connection with the award, performance, or closeout of a contract or any related subcontract. The individual completing this form must be an authorized representative empowered to speak for the company. When you submit this electronic form an email will automatically be generated to send you a copy of what you have submitted. The information you are providing is not deemed to be submitted until you have received that confirmation email. If you wish to provide information that does not fall within these guidelines, please visit the Inspector General Hotline.
Complete this form. If you are unsure if this form applies or you have any questions, please e-mail the Counsel to the Inspector General or call (301) 837-1966.
NARA Office of Inspector General
8601 Adelphi Rd, Suite 1300
College Park, MD 20740-6001
Please provide a complete description of the facts and circumstances surrounding the reported activities, including the evidence forming the basis of this report, the names of the individuals involved, dates, location, how the matter was discovered, potential witnesses and their involvement and any corrective action taken by the company.
provide only the names, business email contact, and business phone for any individuals
involved and/or potential witnesses.
To help us prevent spam, please enter the solution to following math problem. Please enter the answer using numerals (For example, enter 7 not seven).
What is three plus four:
NOTE: You will be able to review your entries before final submission.
The U.S. National Archives and Records Administration
1-86-NARA-NARA or 1-866-272-6272