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Fraud & Non-Compliance Reporting Form

This form is to be used to report workers' compensation fraud and non-compliance of employers who fail to carry required workers' compensation insurance.

DIRECTIONS:  If you know or suspect someone has committed a fraudulent act or is in non-compliance under the Georgia Workers' Compensation Act for failure to have insurance coverage then please complete this form and email, mail, or fax to the:

State Board of Workers' Compensation
Enforcement Division
270 Peachtree Street, N.W.
Atlanta, Georgia  30303-1299
Fax:  (404) 651-7390
Email:  ReportFraud@sbwc.ga.gov

If you need additional information, please call (404) 657-7285.