Benefits Fraud Reporting Form

If you have information regarding possible fraud or misuse of funding for the Low-Income Home Energy Assistance Program (LIHEAP), Low-Income Household Water Assistance Program (LIHWAP), or Weatherization Assistance Program (WAP) in Arkansas, please help us pursue it by completing the online form below

Benefits Fraud Reporting Form

* Asterisk indicates item is mandatory; all others are optional

*I am reporting:

A person who is misusing LIHEAP, LIHWAP, or WAP benefits, or is receiving benefits for which he or she is not entitled.

A business that is misusing LIHEAP, LIHWAP, or WAP benefits.

*Name of the individual or business you are reporting:

Individual or business location information:

If you do not know the full address, tell us the city, town, county, or telephone number, if possible.

Street Address:

City:

State:

ZIP:

Phone:

County:

Other:

Reporting Fraud for Assistance Program

Please indicate the Energy Office program where you would like to direct your complaint.

Low-Income Home Energy Assistance Program (LIHEAP)
Low-Income Household Energy Assistance Program (LIHWAP)
Weatherization Assistance Program (ARWAP)

Details of the suspected fraud or misuse:

Our investigations are most successful when you provide as much information as possible about the allegation and those involved. The more you tell us, the better chance we have of determining whether an investigation can be pursued.

Date(s) of the suspected fraud or misuse:

Agency providing the service: (It is understood that the agency may have no knowledge of the suspected fraud or misuse.)

Approximate dollar amount of fraud or misuse:

*Provide as much information as possible.

Information may include a narrative explaining the nature, scope, time frame, and how you came to learn about the activity in question; the name and contact information of any individual who can help back up the information being reported; and supporting evidence (such as email communications, documents, or photographs) in electronic format.

Attach images or PDF documents:
Up to three .jpg, .gif, .jpeg, .tif, or .pdf documents. Documents must be 10 MB or under, per file.

Contact Information (optional)

Note: Giving us your contact information is optional. We ask that you provide at least your email address so that we can send you a response, but you may remain anonymous if you choose.

I wish to remain anonymous.

Confidentiality and anonymity are not requested.

Name:

Phone:

Email Address:

Email Me a Copy
(email address required)

Thank you for reporting this case of suspected fraud or misuse. An AEO analyst will review your complaint for relevance and completeness. Not all complaints result in an investigation. If you have identified yourself, a reviewing official may contact you for further information. However, if you are not contacted it does not mean your complaint is not being investigated.