| MN Office of the State Auditor (OSA)

Your Name

Your Daytime Phone Number *

Your email address *

Are you an employee or officer of a political subdivision, making a mandated report under Minn. Stat. §609.456, subd. 1?

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No

Are you a public accountant making a mandated report under Minn. Stat. § 6.67?

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No

In the box below, please provide a detailed description of the alleged incident or incidents, including when it or they occurred, who was involved, and how you know what happened. *

Do you have supporting documents or other information that you can provide?

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No

Do you believe this action violated a law, rule, or other standard?

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No

If yes, please explain.

Have you reported this allegation to a government office other than the Office of the State Auditor?

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No

If Yes, please list the government office(s) or official(s) to which you reported the allegation, when you reported the allegation, and any action(s) the office(s) or official(s) took.

Please check the box to confirm you are not a robot.

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