Thank you for submitting your complaint to the Auditor of State’s Office.  
We appreciate your honest concern for holding government officials accountable. 

Your complaint number is %CASENUMBER%. 

Please save this number for your records. Your complaint will be logged into 
the A.U.D.I.T.S. system within 24 hours of filing. If necessary, our office 
will contact you to obtain further information.

If you have any questions or new information regarding your complaint, please 
contact the Auditor of State’s Special Investigations Unit at 1-866-FRAUD OH 
or (614) 466-3786. Please have your complaint number available when you call.


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Submitted Information
Complainant Information
Name
  %CName%		 Position
  %CPosition%
Email Address
  %CEmail%		 Employer/Department
  %CEmployer%
Employer/Department Address
   %CEmployerAddress% 		Work Phone
   %CWorkPhone%
County
  %CEmployerCounty%
Home Address
  %CHomeAddress%		 Home Phone
  %CHomePhone%
County
   %CHomeCounty%
I Wish to Remain Anonymous
  %CAnonymous%
Suspect Information
Name
  %SName%		 Position
  %SPosition%
Employer/Department
  %SEmployer%
Employer/Department Address
   %SEmployerAddress% 		Work Phone
   %SWorkPhone%
County
  %SEmployerCounty%
Home Address
  %SHomeAddress%		 Home Phone
  %SHomePhone%
County
   %SHomeCounty%
Witness
Name
  %WName%		 Title
   %WTitle%		 Work Phone
   %WWorkPhone%
Department
   %WDepartment% 		Home Phone
   %WHomePhone%
Allegation Witnessed
   %WAllegation%
Complaint
Briefly describe the improper activity(ies) and how you know about them.  Specify who, what, when, where, and how.  Number the allegations.

   %Complaint%
When did the event(s) take place? Please indicate date, time, and frequency, if applicable.

   %ComplaintWhen%
Where did the event(s) occur?

   %ComplaintWhere%
Have you reported this information to another agency? 

   %ComplaintReported%
If so, which one? 

   %ComplaintReportedAgency%
If you have disclosed the information reported here, what is the current status of the matter?

   %ComplaintReportedStatus%
How do you know about the information you are disclosing here:

   %ComplaintHowKnown%
Which type(s) of improper governmental action does the complaint(s) involve?  Please check all that apply.  If you know the particular law or regulation that has been violated, please provide it.

   %ComplaintViolationType%
Other Information
Is there any additional information you would like to leave?

   %EvidenceNotes%
Signature (Read the following before submitting the complaint)

PLEASE NOTE: Under Ohio law, complaint forms or letters may at some time become “public records” subject to disclosure under the Ohio Public Records Act. Documents that are deemed to be public records are available to the public, including the media, upon request for review, copying, and release. Since the Internet is not secure, we urge you to send personal identifying information (for example, Social Security number, bank account numbers, or credit card numbers) by U.S. mail rather than via the Internet. When doing so, please reference the complaint number that will be assigned to you. Please be sure to send copies of supporting documents, not the originals.