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Contractor and Grantee Self Report Form

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Contractors and grantees must, in a timely manner, disclose certain criminal acts and civil violations, in writing, to the OIG. Completion of this form meets these obligations.

Contractors: 48 CFR 52.203-13(b)(3) states that the Contractor shall timely disclose, in writing, to the agency Office of the Inspector General (OIG), with a copy to the Contracting Officer, whenever, in connection with the award, performance, or closeout of this contract or any subcontract there-under, the Contractor has credible evidence that a principal, employee, agent, or subcontractor of the Contractor has committed:

  • A violation of Federal criminal law involving fraud, conflict of interest, bribery, or gratuity violations found in Title 18 of the United States Code; or
  • A violation of the civil False Claims Act (31 U.S.C. §§ 3729 - 3733).

Grantees: 2 CFR 200.113 states that the non-Federal entity or applicant for a Federal award must disclose, in a timely manner, in writing to the Federal awarding agency or pass-through entity all violations of Federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the Federal award. Non-Federal entities that have received a Federal award including the term and condition outlined in Appendix XII - Award Term and Condition for Recipient Integrity and Performance Matters are required to report certain civil, criminal, or administrative proceedings to SAM. Failure to make required disclosures can result in any of the remedies described in § 200.338, including suspension or debarment.

If you are not a contractor or grantee, or if you want to report something that is not described above, please use the OIG Hotline Submission Form [MM1] to notify OIG.

WARNING: Do not submit classified information via the online complaint form.  To submit a complaint involving classified information, please submit a complaint form with your contact information, and ONLY specify that your complaint involves classified information – no further details are necessary at this stage. Once your form is received, someone from our office will contact you to further assist in processing your hotline submission.

Fields with a red asterisk (*) are mandatory.

Your Contact Information
Your Employer/Company Address
Contractor/Grantee Information
Please add as many names as are relevant, one per line.
Contractor/Grantee Address
Contract/Grant Information
Incident Details
Do you have any further evidence of this incident such as documents, photos, e-mails, etc.?