WIC Participant Fraud Reporting Form

(First)
(Last)
(if available)
(Please list names and WIC participant ID Numbers (if available))
(if available)
(Please enter the phone number in XXX-XXX-XXXX format.)

In the box below, please provide a description of the suspected WIC participant fraud.  Be sure to include the important details such as names of persons involved and dates if available.  If you are reporting suspected fraud based on an on-line posting, send a copy of the posting to WICfraud@la.gov.

You are able to report suspected WIC Participant fraud anonymously, but if you would like the WIC State Agency to contact you, please complete the fields below: