PPP Loan Fraud Report Form
Use this form to report suspected fraud related to a PPP loan. Provide the incident details and any supporting evidence you have.
Reporter Information
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
*
Email
Phone
No reply needed
Fraud Incident Details
Suspected Fraud Report Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Business or Borrower Name
*
Incident Date or Date Range
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Fraud Type
*
Forged documents
Misuse of loan funds
False employee counts
Duplicate application
Other
Description of Suspected Fraud
*
Evidence and Submission Notes
Supporting Evidence
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Remain anonymous to the borrower
*
Yes
No
Submit Report
Should be Empty: