Page Content *Indicates required field First Name: * Please provide a first name. Last Name: * Please provide a last name. Email Address: * Please enter a valid email address, ex. name@example.com. Phone (Include area code): * Invalid Phone Format. Please enter a valid phone number, ex. 999-999-9999 Best time to contact: NCDOT division or business unit involved: * Required Your relationship to the department * -- Select -- Citizen State employee Vendor or contractor Other (Please explain in the text box below) Required If other, please explain your relationship to the department: Location where incident occurred (Specific office, facility, program, etc.): * Required Individual(s) involved (Name of individuals, position, title, etc.): * Required What is the general nature of this allegation? * Conflict of Interest/Ethics Violation Contract and Procurement Fraud Contractor/Grantee Fraud Embezzlement False Statements, Certifications, etc. (time, travel, etc.) Funds Not Used for Designated Purpose Kickback/Bribes/Extortion Misuse of Government Property/Equipment Misuse of Grant Funds Misuse of Staff Misuse/Abuse of State Time Misuse of State Vehicle Specific Danger to Public Health/Safety Theft of Government Property Violation of Procedures Violation of State Law Regulation Waste of State Funds Other Fraud, Waste or Abuse If other, please explain the general nature of this allegation: How did you become aware of this allegation? * -- Select -- It happened to me Observed it/Saw it happen Overheard/Heard about it later Was told by a state employee/vendor/contractor Discovered a document or file Other (Please explain in text box below) Required If other, please explain how you became aware of this allegation: Please provide detailed information about this incident: * Required Be sure to tell us WHO is involved, WHAT occurred, WHERE the incident occurred, WHEN were the specific or approximate dates and times, HOW LONG the problem has been going on, and any ADDITIONAL INFO like the names of other potential witnesses, the name and location of any files and documents, etc. Upload related files and documents Click the Choose Files button below to attach any files related to this tip. Click the Reset Files button below to clear selected files. You can upload the following file type: Pictures (.jpg, .png) Adobe Acrobat PDF (.pdf) Word documents (.docx) Excel spreadsheets (.xlsx) Text files (.txt) The maximum number of files is 10 and total size limit is 25MB. Reset files Please Contact Us if you need assistance completing this form. Validating Fields Submitting Form Submit 6/9/2023 4:05 PM