Unemployment Insurance Business (Employer/Contractor) Fraud Reporting Form

The Louisiana Workforce Commission aggressively investigates all fraud tips and complaints submitted to our office. To report someone you suspect may be committing Unemployment Insurance Tax fraud, complete the information below and press the Submit button. You may choose to submit this information anonymously; however, doing so may limit our ability to effectively investigate the situation.

1. * Name of the company or person you are reporting:
   
2. Address, city, state, and telephone number of the company or person:
   
   Character Count: (Max 200, remaining 200.)
3. Name of principals and/or owners:
   
   Character Count: (Max 200, remaining 200.)
4. Type of business:
   
   Character Count: (Max 200, remaining 200.)
5. * Worker's primary duties:
   
6. Business does not report employees to the Office of Unemployment Insurance Administration
   YES: NO: Unknown:
7. Business does not accurately report the amount of wages for its employees
   YES: NO: Unknown:
8. Business pays workers "under the table" or "off the books" (for example, pays in cash)
   YES: NO: Unknown:
9. Business misclassifies workers as independent contractors and does not report wages on IRS W-2 forms (sometimes payments to misclassified workers are reported on IRS 1099 forms)
   YES: NO: Unknown:
10. Do you have documents or other information that support your suspicions? If so, please describe what documents you have.
    
    Character Count: (Max 200, remaining 200.)
11. If you wish to be contacted by this office, please give us your name, address, telephone number, and/or email address.
    
    Character Count: (Max 200, remaining 200.)
    
    E-Mail:
12. Please provide any additional information you feel is important (additional addresses/locations, Federal Tax ID #, number of known workers, etc.).
    
    Character Count: (Max 200, remaining 200.)

If you have any other questions, please call toll-free 1-800-201-3362.