Unemployment Insurance Business (Employer) Fraud Reporting Form
The Nebraska Department of Labor 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.
|
|
(*) Required Fields
|
|
1. * Name of the company or person you are reporting:
|
2. Address, city, state, and telephone number of the company or person:
|
3. Name of principals and/or owners:
|
4. Type of business:
|
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.
|
11. If you wish to be contacted by this office, please give us your name, address, telephone number, and/or email address.
Email:
|
12. Please provide any additional information you feel is important (additional addresses/locations, Federal Tax ID #, number of known workers, etc.).
|
|
|
NEworks
