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2. Name of the person you suspect
3. Where they live
5. Type of fraud

   1. Unreported income
   2. Unreported household member
   3. Other
7. Why do you suspect this person?

9. This information to Steuben County will be completely anonymous. No personal information about you (i.e. e-mail address) is collected or sent to anyone.

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11. 1. Receive an email copy of this form.
12. Email address

    This field is not part of the form submission.

13. Submit

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