Form FF-0950 "Information Referral" - New Jersey

What Is Form FF-0950?

This is a legal form that was released by the New Jersey Department of the Treasury - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2018;
  • The latest edition provided by the New Jersey Department of the Treasury;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form FF-0950 by clicking the link below or browse more documents and templates provided by the New Jersey Department of the Treasury.

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Download Form FF-0950 "Information Referral" - New Jersey

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State of New Jersey • Department of the Treasury
DIVISION OF PENSIONS & BENEFITS — PENSION FrauD aND aBuSE uNIT
P.O. Box 295, Trenton, NJ 08625-0295
INFOrMaTION rEFErraL
SECTION a — INFOrMaTION aBOuT THE PErSON YOu arE rEPOrTING
________________________________________________________________________________________________
Name of Subject
Date of Birth
________________________________________________________________________________________________
Street Address
City
State
ZIP
________________________________________________________________________________________________
Former Occupation and Place of Employment
________________________________________________________________________________________________
Address
________________________________________________________________________________________________
Current Occupation and Place of Employment
________________________________________________________________________________________________
Address
SECTION B — DESCrIBE THE aLLEGED FrauD Or aBuSE (Attach additional sheet if needed.)
Documents available (if any): ________________________________________________________________________
SECTION C — INFOrMaTION aBOuT YOu
We do not share this information with the person you are reporting. This information is not required to process your report
but it is essential if we do have a question or require additional information from you.
________________________________________________________________________________________________
Your Name
Email Address
Telephone #
Best Time to Call
________________________________________________________________________________________________
Street Address
City
State
ZIP
You may submit this referral by email to pension.fraud@treas.nj.gov, by fax to (609) 777-0404 or mail it to:
New Jersey Division of Pensions and Benefits
Pension Fraud and abuse unit
P.O. Box 295
Trenton, NJ 08625-0295
FOr NJDPB uSE ONLY
___________________________________________
____________________________
______________
Intake Officer’s Name
Subject’s Membership No. or Retirement No.
Date Received
Send by Email
Print Form
State of New Jersey • Department of the Treasury
DIVISION OF PENSIONS & BENEFITS — PENSION FrauD aND aBuSE uNIT
P.O. Box 295, Trenton, NJ 08625-0295
INFOrMaTION rEFErraL
SECTION a — INFOrMaTION aBOuT THE PErSON YOu arE rEPOrTING
________________________________________________________________________________________________
Name of Subject
Date of Birth
________________________________________________________________________________________________
Street Address
City
State
ZIP
________________________________________________________________________________________________
Former Occupation and Place of Employment
________________________________________________________________________________________________
Address
________________________________________________________________________________________________
Current Occupation and Place of Employment
________________________________________________________________________________________________
Address
SECTION B — DESCrIBE THE aLLEGED FrauD Or aBuSE (Attach additional sheet if needed.)
Documents available (if any): ________________________________________________________________________
SECTION C — INFOrMaTION aBOuT YOu
We do not share this information with the person you are reporting. This information is not required to process your report
but it is essential if we do have a question or require additional information from you.
________________________________________________________________________________________________
Your Name
Email Address
Telephone #
Best Time to Call
________________________________________________________________________________________________
Street Address
City
State
ZIP
You may submit this referral by email to pension.fraud@treas.nj.gov, by fax to (609) 777-0404 or mail it to:
New Jersey Division of Pensions and Benefits
Pension Fraud and abuse unit
P.O. Box 295
Trenton, NJ 08625-0295
FOr NJDPB uSE ONLY
___________________________________________
____________________________
______________
Intake Officer’s Name
Subject’s Membership No. or Retirement No.
Date Received