Contact Us Name *FirstLastAddress *Telephone *Email *Provide Details of False Claim: *Provide as much detail about fraud here. Include name of person, partnership or corporation that is defrauding the government.Date Fraud BeganIs Fraud Still Happening *YesNoDescribe Evidence of Fraud. Describe evidence of fraud, including the existence of any documents, whether your knowledge of fraud is first hand, the names of any witnesses and whether they would be willing to testify.Estimate of Money Lost *Estimate of Money Lost by Government as a result of fraud. Specify dollar amount.What is your position with company that committed fraud?Who Have You Told About Fraud?Specify who you have told about Has the Fraud Been Reported to the Public?Describe here whether fraud was reported in the media.Has the Government taken any action regarding the fraud?State whether the government has filed charges against the company or began an investigation.Are You Willing to Make Your Charges Public by filing a lawsuit?YesNoIs there Any Other Relevant Information?Specify here any other relevant information that was not listed above.I understand that by submitting this information, I am not forming an attorney-client relationship with Mr. Pearline, and that such a relationship can only be formed by both myself and Mr. Pearline executing a representation agreement. Checkboxes *Please check here to acknowledge that you understand this statement.NameSubmit
