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Justice for Fraud Victims Project
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Justice for Fraud Victims Project
Testimonials
Report an Embezzlement
In the News
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* = Required Fields
*
Who is the Victim?
--Select One--
Me
My Dependent
Business
Other Person
Personal Information
*
First Name:
*
Middle Initial:
*
Last Name:
*
Address:
*
City:
*
State:
Choose a State
Alaska
Alabama
Arkansas
Arizona
California
Canada
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vermont
Washington
Wisconsin
West Virginia
Wyoming
*
Contact Phone:
*
Type of Phone:
--Select One--
Home
Work
Cell
Message
*
Is your phone a hard of hearing device?:
--Select One--
Yes
No
E-mail Address:
*
Contact Preference:
--Select One--
Phone
E-mail
Business Information
*
Business Name:
*
Business Address:
*
Business Phone:
Victim's Information
*
Victim's Full Name:
*
Victim's Address:
*
Victim's Phone:
Location Where Incident Occurred
*
Do you have video or other evidence of the suspect and/or incident?
No
Yes
Describe the video and/or other evidence:
*
Address:
*
City:
*
State:
*
Other:
This Incident Occurred Between
*
Date:
/
/
*
Time:
:
AM
PM
To
*
Date:
/
/
*
Time:
:
AM
PM
Suspect Information
*
Do you have any suspect information?
No
Yes
Witness Information
*
Have you spoken with others to ask them if they saw or heard anything?
No
Yes
If "yes," how many witnesses were involved?
Related Report
Narrative
*
Explain, in chronological order, what happened. Who, What, When, Why and How.
We will e-mail a response to you unless you specifically request a phone call and provide a valid phone number. This may take up to 3 business days. If you have not received a response after 3 business days, please call JFVP to determine the status of your information (contact information on main page.)
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