In order to proceed with a False Claims or Qui Tam case, we will need to know who was responsible for or involved in the fraud, and what evidence is there to prove it. A False Claims lawsuit must be more than general allegations and speculations.

Please help us evaluate the merits of your case by answering a few questions. All information will be held in complete confidence.

 

Case Evaluation

First Name:	Last Name:
Phone #:	Email:

 

1.	Is the type of fraud or overbilling related to State or Federal Income Tax evasion?
	Yes No

 

2.	Is this a fraud related to a contract between a U.S. governmental entity and a private contractor? (For example: Fraud or overbilling on government contracts such as Medicare, defense contracts, construction contracts, grants, etc.) Note: Fraud related to a contract between individuals or non-government entities (e.g. inheritance, estates, trusts) does NOT fall under the False Claims Act.
	Yes No

 

3.	What documentary evidence do you have – or have access to – of the fraud? Please check all that apply.
	Documents Computerized Data Audio or Video Recordings Journal Records Eyewitness Testimony

 

4.	What field does the fraud relate to? Please check all that apply.
	Medical Defense Construction Agriculture Federal Government State Government Municipal Government Education/Research Other

 

5.	Please estimate the total dollar value of the fraud or overbilling over the period it occurred. Base estimate on what you are personally aware of.
	Under $10,000 $10,000 to $100,000 $100,000 to $500,000 $500,000 to under $1 million Over $1 million

 

6.	Do you believe this type of fraud is part of a pattern and practice that is widespread within the offending company or industry?
	Yes No
	If YES, please estimate the total amount of fraud that further investigation would reveal.
	Under $100,000 $100,000 to $500,000 $500,000 to under $1 million $1 million to $2.5 million $2.5 million to $5 million More than $5 million