COUNTY OF SUFFOLK
SUFFOLK COUNTY EXECUTIVE
DEPARTMENT OF SOCIAL SERVICES
Request for Investigation of Welfare Fraud
Required fields are marked with an *.
* Client First Name:
* Client Mailing Address Line 1:
* Client Last Name:
Client Mailing Address Line 2:
Client Phone Number: xxx-xxx-xxxx
* Client City:
Client Date of Birth: MM/DD/YYYY
* Client State:
Select State
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* Client Zip:
* Description of Alleged Fraud (Max Characters 1000):
Note: Please include information that would assist Investigators: For example, description of client,
places of suspected employment, source of benefits or compensation, assets, bank accounts,
description of absent parent, activity and employment, description of car(s) and license number(s).
The following fields are
REQUIRED
when submitting this form online.
* Your First Name:
* Your Last Name:
* Your Phone: xxx-xxx-xxxx
* Your Email:
 
Please check the box to continue.
I AM NOT A ROBOT.