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Contractor Report Form

This format is provided as a convenience to contractors for reporting certain violations of Federal criminal and civil law as required under Federal Acquisition Regulation (FAR) contract clause 52.203-13, "Contract Code of Business Ethics and Conduct" (December 2008). Specifically, a contractor may use this form to satisfy the requirement in paragraph 9(c)(2)(ii)(F) of the clause that the contractor notify the agency (HUD Office of the Inspector General), in writing, 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, bribery, 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 a representative of the company authorized to report the information in this format.

When you submit this form via email, an email will automatically be generated to send you a tracking number and a copy of your submission. The information you are providing will not be deemed to have been submitted as required by FAR clause 52.203-13 until you have received that confirmation email. If you wish to provide information that does not fall within these guidelines, please visit the Inspector General Hotline.

Contractor Information
Company Information
e.g. 00000
HUD Contract Information
e.g. 000-000-0000
Violation Information
Certifications
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