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FAR Contractor Reporting Form

To implement the December 12, 2008 FAR amendment, this form is to allow contractors to notify, in writing, the NSF Office of Inspector General, whenever the contractor has credible evidence that a principal, employee, agent, or subcontractor of the contractor has committed a violation of the civil False Claims Act or a violation of Federal criminal law involving fraud, conflict of interest, briber, or gratuity violations in connection with the award, performance, or closeout of a contract or any related subcontract.

The individual completing this form must be an officer or manager empowered to speak for the company by filing this report. If you wish to provide information that does not fall within these guidelines, please visit the Inspector General Hotline.

Use this area to provide us with information about yourself:


Address, E-mail, phone number:

Use this area to give us a description of the Violation:

Description of Concern / Estimated Amount of Loss:
Description and location of relevant evidence:

Use this area to give us information about the company / people involved:
Name(s) / DUNS / TIN:
Contact Information:
Other Information:
Information about others who may provide more or supporting information:

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