{"id":7822,"date":"2019-11-07T20:19:34","date_gmt":"2019-11-07T20:19:34","guid":{"rendered":"https:\/\/www.nicholls.edu\/internal-audit-department\/?page_id=7822"},"modified":"2019-11-08T16:23:56","modified_gmt":"2019-11-08T16:23:56","slug":"anonymous-fraud-report-form","status":"publish","type":"page","link":"https:\/\/www.nicholls.edu\/internal-audit-department\/anonymous-fraud-report-form\/","title":{"rendered":"Anonymous Fraud Report Form"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_3' >\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Anonymous Fraud Report<\/h3>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_3'  action='\/internal-audit-department\/wp-json\/wp\/v2\/pages\/7822' data-formid='3' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_3_1\" class=\"gfield gfield--type-name field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Contact Information (optional)<\/label><div class='gfield_description' id='gfield_description_3_1'>While this information is optional, providing us with your name and telephone number will allow us to contact you with any additional questions.<\/div><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_3_1'>\n                            \n                            <span id='input_3_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_3_1_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_3_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_3_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_3_1_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_3_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_3_2\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_2'>Title<\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_3_2' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_3_3\" class=\"gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_3'>Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_3_3' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_3_4\" class=\"gfield gfield--type-email field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_4'>Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_3_4' type='email' value='' class='medium'     aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_3_5\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Report Information<\/h2><\/li><li id=\"field_3_6\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_6'>1.\tDepartment Where the Suspected Improper Activity Occurred<\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_3_6' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_3_7\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_7'>2. Financial Org Number (if known):<\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_3_7' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_3_8\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_8'>3. Name of person(s) involved in the improper activity<\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_3_8' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_3_9\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >4. What type of fraud, waste or abuse are you reporting?<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_3_9'><li class='gchoice gchoice_3_9_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.1' type='checkbox'  value='Theft of Public Funds and\/or Equipment'  id='choice_3_9_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_9_1' id='label_3_9_1' class='gform-field-label gform-field-label--type-inline'>Theft of Public Funds and\/or Equipment<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_9_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.2' type='checkbox'  value='Personal Use of Public Funds and\/or Equipment'  id='choice_3_9_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_9_2' id='label_3_9_2' class='gform-field-label gform-field-label--type-inline'>Personal Use of Public Funds and\/or Equipment<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_9_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.3' type='checkbox'  value='Public Official\/Employee Doing Business With Himself\/Herself'  id='choice_3_9_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_9_3' id='label_3_9_3' class='gform-field-label gform-field-label--type-inline'>Public Official\/Employee Doing Business With Himself\/Herself<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_9_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.4' type='checkbox'  value='Public Official\/Employee Accepting Something of Value (or Kickback) From a Vendor'  id='choice_3_9_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_9_4' id='label_3_9_4' class='gform-field-label gform-field-label--type-inline'>Public Official\/Employee Accepting Something of Value (or Kickback) From a Vendor<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_9_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.5' type='checkbox'  value='Public Official\/Employee Paying for Work Not Performed by Vendor'  id='choice_3_9_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_9_5' id='label_3_9_5' class='gform-field-label gform-field-label--type-inline'>Public Official\/Employee Paying for Work Not Performed by Vendor<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_9_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.6' type='checkbox'  value='Public Official\/Employee Paying Excessive Amounts for Services'  id='choice_3_9_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_9_6' id='label_3_9_6' class='gform-field-label gform-field-label--type-inline'>Public Official\/Employee Paying Excessive Amounts for Services<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_9_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.7' type='checkbox'  value='Public Official\/Employee Falsifying Expense Reimbursements'  id='choice_3_9_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_9_7' id='label_3_9_7' class='gform-field-label gform-field-label--type-inline'>Public Official\/Employee Falsifying Expense Reimbursements<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_9_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.8' type='checkbox'  value='Public Payroll Fraud'  id='choice_3_9_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_9_8' id='label_3_9_8' class='gform-field-label gform-field-label--type-inline'>Public Payroll Fraud<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_3_9_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.9' type='checkbox'  value='Other fraud, waste or abuse (detail below)'  id='choice_3_9_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_9_9' id='label_3_9_9' class='gform-field-label gform-field-label--type-inline'>Other fraud, waste or abuse (detail below)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_3_10\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_10'>Other fraud, waste or abuse details from above (if selected above)<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_10' id='input_3_10' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_3_11\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_11'>5. When did the potential improper activity occur?<\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_3_11' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_3_12\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_12'>6. Describe the potential improper activity in detail (include dates, time, witnesses, etc if possible) (Required)<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_12' id='input_3_12' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_3_13\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_13'>7.\tWhen did you discover or become aware of the improper activity?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_13' id='input_3_13' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_3_14\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_14'>8. How long has the improper activity been going on?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_14' id='input_3_14' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_3_15\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >9. Is the potential improper activity continuing?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_3_15'>\n\t\t\t<li class='gchoice gchoice_3_15_0'>\n\t\t\t\t<input name='input_15' type='radio' value='YES'  id='choice_3_15_0'    \/>\n\t\t\t\t<label for='choice_3_15_0' id='label_3_15_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_3_15_1'>\n\t\t\t\t<input name='input_15' type='radio' value='NO'  id='choice_3_15_1'    \/>\n\t\t\t\t<label for='choice_3_15_1' id='label_3_15_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_3_16\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_16'>10. Please list the names of people who may be able to help\/cooperate in an investigation:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_16' id='input_3_16' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_3_17\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_17'>Additional Comments:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_17' id='input_3_17' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_3_19\" class=\"gfield gfield--type-fileupload field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_3_19'>Thank you for helping fight fraud, waste and abuse at ÐÓ°É´«Ã½.  Any records\/documentation that you can provide to assist with the investigation can be uploaded and attached to this form. If you choose to assist by providing your contact information, your contact information, as well as the status of your complaint, are CONFIDENTIAL. \n \nSUBMISSION OF THIS FORM AND ATTACHMENTS TO THIS FORM ARE ANONYMOUS.<\/label><div class='gfield_description' id='gfield_description_3_19'>Thank you for helping fight fraud, waste and abuse at ÐÓ°É´«Ã½.  Any records\/documentation that you can provide to assist with the investigation can be uploaded and attached to this form. 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