Tips Form

All faculty, staff, students, and stakeholders have an obligation to help protect the University's assets and reputation. If you suspect suspicious activity such as fraud, misuse, misappropriation, etc., please complete the following information and email it directly to the Office of Internal Audit.

Personal Data

Concerns can be submitted anonymously. This form is e-mailed directly to the Office of Internal Audit via our Web server and your e-mail address is not visible anywhere unless you choose to include it. The form does not record any personal information (such as an e-mail or IP address) unless you provide it. Please keep in mind, however, that the effectiveness of an investigation is contingent upon the accuracy of the details submitted. Please click on the link below for details on the state's Whistleblowers' Protection Act:

http://www.michiganlegislature.org/documents/mcl/pdf/mcl-Act-469-of-1980.pdf

Contact Information

(Optional: This information is not required for anonymous tips. If you choose to enter your contact information, it will be included in the information emailed to Internal Audit.)

Name

Title

Department

Phone

Fax

Email Address

Detailed Information

Please provide as much information as possible regarding your concerns. Incomplete or inaccurate information significantly hinders our ability to perform a thorough investigation. Items marked with an asterisk (*) are required.

Name(s) ofIndividual(s) Involved *

Title(s)

Phone #(s)

Department(s)*

Alleged Action(s) *

Banner Index #(s) used, if known and applicable

How long has this been occuring?

Total dollar amount of possible loss

Have you reported this incident to anyone else? If so, please list their name(s) and phone number(s) (i.e., dean, director, supervisor, Public Safety, etc.) *

How did you become aware of this incident?

What is your relationship with the individual(s) listed above?

May we contact you for further information?

Yes

Thank you for your time and the information you have provided. It will be most helpful in conducting our investigation. All tips will be recorded and evaluated.

Tips related to other areas of governance (i.e., Human Resources, Equal Employment Opportunity, Research, Provost's Office, etc.) will be forwarded to the appropriate department for further review in accordance with their respective policies and procedures.

If you wish to contact Internal Audit directly, please call us at (313) 577-2128 or see the Staff Directory to email us. We appreciate your assistance in helping to protect the University's resources.