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Chenango County DSS Fraud Reporting Form

Report Fraud Committed by a Department of Social Services Client, Provider or Vendor in Chenango County, NY. If you are not reporting a fraud committed in Chenango County, NY or by a Chenango County Resident, Provider or Vendor, please contact your local Department of Social Services.

Fight Welfare Fraud! Use this form to report a client that you believe has fraudulently received assistance from programs administered by the Chenango County Department of Social Services. This includes but is not limited to Temporary Family Assistance, Food Stamps, HEAP, Medical Assistance and Daycare.

Examples of situations that are fraudulent are: unreported income (either earned or unearned), hidden assets (bank accounts, property, etc.), unreported changes in household composition (either someone moved into the home or moved out), changes in shelter cost, etc.

If you want to report fraud committed by a provider or vendor you should do so by also completing this form.

If you suspect or have knowledge of fraud fill in the form below. You may then submit the form electronically.

(*) Required Fields.

 

Your name and phone number are optional but would be helpful to us in case we need to contact you for additional or clarifying information.
Please input your name
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Please input your street address
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Please input your city
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Your State (*)
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Please input your zip code (*)
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Please input your email address
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Please input your phone number
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Please input information regarding the suspected fraud.
Please choose the fraud type (*)
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Please input the name of fraud suspect
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Please input the address of fraud suspect
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Please input the city of fraud suspect
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Please choose the state of fraud suspect
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Please input the zip code of fraud suspect
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Please input the date of birth of fraud suspect (mm/dd/yyyy)
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Please enter ALL the information you have regarding the allegation or suspicion of how the client(s) is defrauding the department (*)
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Please input the text from the image.
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COB-Annex
Chenango County

Department of Social Services
County Office Building
5 Court Street
Norwich, NY 13815

Hours: 8:30AM - 5:00PM (Monday - Friday)
Phone: 607.337.1500
Toll Free: 877.337.1501
Fax: 607.337.1525

E-mail Inquiries