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Confidential Case Evaluation

The purpose of this form is to provide basic information that our law firm will use to evaluate your potential qui tam case. We will treat all information you provide through this form as privileged and confidential. If you have any concerns about providing your information through this website, please feel free to call our Washington, D.C. office at (202) 973-0900 to provide your information by telephone, or send your information to our office at 2000 L Street, N.W., Suite 808, Washington, D.C. 20036.

Please note that, in general, we only handle cases in which a business or company has committed fraud on the government and the amount of the fraud is at least $1 million.


Information we will need to contact you:

Name:

Telephone 1:

Email:

Information about the company you believe is committing fraud on the government:

Name of Company:

What type of products or services does the company provide?

Are you current or former employee of the company?

Information about the fraud:

Describe the fraud in as much detail as you can.

Provide your best estimate of the amount of money the company has received from the government as a result of the fraud.