Whistleblower Case Inquiry

Please complete the following form. An attorney should contact you within one business day about your submission.

The information that you submit below will be STRICTLY CONFIDENTIAL and will not be shared with anyone.

Please understand submitting this form does not create an attorney-client relationship and does not retain our services as your attorney.

Personal Information
Title:
First Name *:
Middle Initial:
Last Name *:
Address:
City:
State:
Zip:
Day Time Telephone *:
Evening Telephone:
Mobile Telephone:
Email:
Best Way To Reach You:

Case Information
Company / Companies allegdly involved in fraud?
Your position in the company allegedly involved in the fraud?
Are you still employed by the company allegedly involved in the fraud?
Have there been any “public disclosures” of the potential fraud?
When did the fraud begin?
Have you reported the fraud to the company or anyone else?
If yes, have you experienced retaliation or discrimination since you reported the fraud?
Are your allegations the subject of any legal or legislative action, by, for example, a congressional hearing, another lawsuit or agency proceeding?
How much in damages would you estimate the government has been damaged by the alleged fraud ?
Have you ever filed a lawsuit against anyone or the company before?
Do you know of any possible events that might preempt your claim?
Please describe briefly below the nature of the alleged fraud?

 

Law Offices of Michael Scott Green, Esq.
86 Washington Avenue
Milltown, New Jersey 08850
Tel: 732-390-0480
Law Offices of Alex Pagano, PhD, Esq.
30 Vreeland Road, Bldg. A, Suite 230A – Florham Park, New Jersey 07932
Tel: 973-301-2228
David Schwartz, Esq.
Schwartz & Posnock
901 West Park Avenue, Suite 2-E
Ocean, NJ 07712
732-695-1902
Anthony R. Fiore, Esq.
Danzig, Kaye, Cooper, Fiore & Kay, LLP
30 Vreeland Road, Florham Park, NJ 07932
Tel: 973-443-0600