P O Box 819 Macon, GA 31202-0819 P. 478-751-3500 F. 478-751-3465 An Equal Opportunity Employer & Service Provider GFC Fraud Alert Form Sonny Perdue Governor Report all Federal Stimulus (ARRA) Fraud, Waste and Abuse immediately upon being made aware of any such situation using the below form and emailing this form immediately upon completion to [email protected]. Robert D. Farris Director Date: Board of Commissioners: Memo To: Barbara Dunn – [email protected] Wesley Langdale, Chairman Valdosta Victor Beadles Moultrie Jim L. Gillis, Jr. Soperton H. G. Thomas New Louisville Robert Pollard Appling Fred Warnell Richmond Hill From: Subject: Please be advised that the above office has received a complaint and opened an inquiry and/or case involving the below listed business/person(s). 1. Business of Interest: Note Corporate/Vendor name, address, and phone number(s): H. G. Yeomans Swainsboro 2. Person(s) of Interest: Note name address, phone number or other identifying information: 3. Person making allegations: (Name, address, phone number) 4. Allegations: Briefly describe nature of allegations, type of suspected fraud: 5. Location of Activity: Provide location(s) in Georgia where activity(s) is occurring: Below to be completed by GFC Investigative Team 1. 2. 3. 4. 5. 6. Report the above allegations within 24 hours of receipt to the OIG office at www.oig.georgia.gov Review internally with Stimulus Fraud reporting team (a person to be assigned from HR, Administration and Investigation Divisions of the Agency). Internal team makes report of recommended corrective action and reports to the Director, Program Director, and Grant Manager responsible for the grant upon which the above allegations are made. Recommendations are implemented. GFC Investigative team makes follow up visit to confirm corrective actions have been properly implemented as directed and files report with OIG. Investigative team addresses any additional concerns of OIG office in regard to the above allegation.
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