NLRB OIG Contractor Reporting Form
This form is provided as a convenience to allow contractors to comply with the
reporting requirements in the December 12, 2008, FAR amendment,
73 Fed. Reg. 67064. Specifically, contractors may use this
form to satisfy the requirement that they notify, in writing, the National
Labor Relations Board (NLRB) Office of the Inspector General, 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 an
authorized representative empowered to speak for the
contractor. After you submit the form data, you will see a report
confirmation screen that you print for your records. If you wish to
provide information that does not fall within these guidelines, please visit
the
Inspector General Web page.
Instructions: Fill in the information below. If you are unsure
if this form applies or you have any question., please contact Counsel to the
Inspector General at OIG Hotline or
call (202) 273-1960.
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