Suspected Fraud/Criminal Activity Complaint Form (#REM-LSNG-310)

The Tacoma Housing Authority (THA) is dedicated to providing quality affordable housing opportunity and to build communities through partnerships. We encourage self-sufficiency and we protect the dignity of people with limited resources while safeguarding the public trust. THA vigorously pursues fraud and criminal activity allegations and strongly encourages those with information regarding fraud/criminal activity pertaining to clients, tenants, and landlords, to notify THA by completing this form or contacting us at 253-207-4400.

The information provided in this form will be viewed by THA staff only. If you wish to leave your information below, it will only be used to contact you for clarification or gather further information.

Date: * +

Name of Subject: *

Property: *

Address: *

The subject is a: *

I am reporting one or more of the following (check all that apply): *

Unauthorized Occupant

Unreported Income

Drug/Criminal Activity

Other Other

Unauthorized Occupant

Unauthorized Occupant #1

How many unauthorized occupants are there?: *

Name of Unauthorized Occupant: *

The unauthorized occupant is a: *

Minor

Adult

Is the unauthorized occupant employed or receiving other income? *

Please explain: *

0/255 characters

Does the unauthorized occupant receive mail at the address? *

Unauthorized Occupant #2

Name of Unauthorized Occupant: *

The unauthorized occupant is a: *

Minor

Adult

Is the unauthorized occupant employed or receiving other income? *

Please explain: *

0/255 characters

Does the unauthorized occupant receive mail at the address? *

Unauthorized Occupant #3

Name of Unauthorized Occupant: *

The unauthorized occupant is a: *

Minor

Adult

Is the unauthorized occupant employed or receiving other income? *

Please explain: *

0/255 characters

Does the unauthorized occupant receive mail at the address? *

Unreported Income

Please provide any information regarding the amount or source of the income: *

Drug/Criminal Activity

Who is involved? (Check all that apply): *

Client

Tenant

Landlord/Owner

Have the police been notified? *

Details on notifying police: *

Have any arrests been made? *

Who was arrested? *

Officer name or agency, if known. (i.e., TPD, Pierce County Sheriff): *

Please provide any additional details related to the complaint:

Although it is not required, providing contact information will allow THA to reach out to you to clarify any details and gather any further information. If you would not like to be contacted, leave the boxes blank and select “Submit”

Name:

Phone:

Email: