Request for Investigation of Unemployment Insurance Fraud Completed Form Examples and Samples
View professional examples and samples of a Request for Investigation of Unemployment Insurance Fraud. Learn how to accurately fill out fraud reporting forms with our guided templates.
Unemployment Insurance Fraud Reporting Example
How this form was filled:
This example demonstrates how an AI can parse an informal whistleblower email and extract specific entity data to populate a formal government 'Request for Investigation of Unemployment Insurance Fraud' document, ensuring accuracy even when the source information is conversational.
Source document used: Whistleblower Complaint Email
Subject: Urgent: Fraud Report regarding Marcus Thorne To Whom It May Concern, I am writing to report suspicious activity regarding Marcus Thorne, who I know as a former coworker. He has been collecting unemployment benefits since he left our company last year, but he actually started a full-time position at 'TechFlow Solutions' located at 4500 Innovation Drive, Rockville, MD 20850. He began his employment there on February 12, 2026. It is frustrating to see him brag about his new salary while continuing to certify for benefits online every week. I have seen his LinkedIn updates and he clearly works there full-time. I am not entirely sure of his exact Social Security Number, but his current home address is 122 Oak Street, Apartment 4B, Baltimore, MD 21202, and his personal cell number is 410-555-0198. I’ve decided to come forward because it’s unfair to those of us who follow the rules. My name is Sarah Jenkins, and you can reach me at 410-555-7723 if you need any follow-up information. I would prefer that my name remains confidential, so please do not release my identity to the claimant during your investigation. I hope this helps the department recover these misspent funds. Let me know if you need anything else from my end regarding his schedule or other evidence I might have gathered.
Information used to fill out the document:
- Claimant: Marcus Thorne
- Employment: TechFlow Solutions (Started Feb 12, 2026)
- Contact Info: 122 Oak Street, Baltimore, MD 21202; 410-555-0198
- Reporter: Sarah Jenkins (410-555-7723)
- Anonymity: Requested
What this filled form sample shows:
- Automatic identification of claimant status versus reporter details
- Extraction of relevant employment dates from informal narrative text
- Flagging of confidentiality preferences for the investigator
- Normalization of address and contact data into structured form fields
Form specifications and details:
| Form Name: | Request for Investigation of Unemployment Insurance Fraud |
| Jurisdiction: | Maryland Department of Labor |
| Target Agency: | Benefit Payment Control |
| Processing Mode: | AI-Driven Extraction |
| Keywords: | unemployment fraud, report fraud, benefit investigation, employment verification |
| Categories: | employment forms, insurance forms, insurance request forms |
| Created: | May 25, 2026 07:29 PM |