Railroad Retirement Board - Office of Inspector General Hotline
SPECIAL COMPLAINT FORM
To provide information concerning fraud, waste or abuse against the programs of the
U.S. Railroad Retirement Board (RRB), or information concerning misconduct by a RRB
employee or management official, please complete the information requested on this
form and mail it to:
Railroad Retirement Board
Office of Inspector General Hotline
844 North Rush Street, 4
th
Floor
Chicago, Illinois 60611
ALLEGATION MADE CONCERNING (PLEASE CHECK APPROPRIATE BOX)
RRB Benefit Fraud Railroad Medicare Fraud
Unemployment
Sickness Railroad Employer Fraud
Retirement
Disability RRB Employee Misconduct
RRB Management/SES Misconduct
Other – Describe in Summary Section on Next Page
ALLEGED VIOLATOR’S IDENTIFYING INFORMATION
Please provide as much information as possible to identify the alleged violator. If the
violator is operating a business, make sure to include that information as well.
Person
Name
Address
Address2
City, State, Zip
Telephone No.
Date of Birth
Soc. Sec. No.
Business, Entity or Additional Person if Necessary
Name: Business,
Entity or Person
Address
Address2
City, State, Zip
Telephone No.
Owner’s Name
Soc. Sec. No.
