Alabama Fire Marshal's Office

Report Suspected Fraud

The State Fire Marshals Office invites anyone with information regarding Insurance Fraud to submit information about the crime through this website online tip form. The information will be relayed directly to the Insurance Fraud Bureau.  The information you provide will be maintained in the strictest of confidence.

NOTE! This form is intended to be utilized by individuals reporting insurance fraud.

Fraud Tip Line: 1-800-654-0775

*  Required

*  COUNTY where the crime occurred:
Select County Autauga Baldwin Barbour Bibb Blount Bullock Butler Calhoun Chambers Cherokee Chilton Choctaw Clarke Clay Cleburne Coffee Colbert Conecuh Coosa Covington Crenshaw Cullman Dale Dallas Dekalb Elmore Escambia Etowah Fayette Franklin Geneva Greene Hale Henry Houston Jackson Jefferson Lamar Lauderdale Lawrence Lee Limestone Lowndes Macon Madison Marengo Marion Marshall Mobile Monroe Montgomery Morgan OutofState Perry Pickens Pike Randolph Russell Shelby St. Clair Sumter Talladega Tallapoosa Tuscaloosa Walker Washington Wilcox Winston Select County!

*  CITY where the crime occurred:
Enter City!

* ADDRESS where the crime occurred:
Enter Address!

ZIP CODE where the crime occurred:
Invalid Zip Code!

*  DATE the crime occurred (As Known):
(MM/DD/YYYY) Enter Date Crime Occurred!

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Reporting Individual Information (Victim or Witness)

I wish to remain Anonymous
CitizenLaw EnforcementFire Service

Last Name:


First Name:


Middle Name:


Business Name:


Contact Telephone:
(XXX) XXX-XXXX

Contact Fax:
(XXX) XXX-XXXX

Email Address:
Invalid Email Address!

Mailing Address:


City:


State:
AL AK AL AR AZ CA CN CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

Zip Code:
Invalid Zip Code!

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Primary Suspect - Person Believed to Have Committed Crime

Business Name:


* Last Name:
Required

* First Name:
Required

Middle Name:


Social Security Number:
XXX-XX-XXXX
Date of Birth:
(MM/DD/YYYY)

Race:
American Indian Arabic Black East European East Indian Hispanic White Other

Sex:
Female Male

Vehicle License Plate Number:


Vehicle License Plate State
AL AK AL AR AZ CA CN CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

Vehicle Identification Number:


Driver's License Number:


Fictitious Names, Alias, Married or Maiden:


Distinguishing marks, scars, tattoos, etc.:


Place of Employment, School, or General Hangout:


Telephone:
(XXX) XXX-XXXX
Fax:
(XXX) XXX-XXXX

E-Mail Address:
Invalid Email Address!

Physical Address:


* City:
Required

* State:
AL AK AL AR AZ CA CN CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Required

Zip Code:
Invalid Zip Code!

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Second Suspect - Person Believed to Have Committed Crime

Business Name:


Last Name:


First Name:


Middle Name:


Social Security Number:
XXX-XX-XXXX

Date of Birth:
(MM/DD/YYYY)

Race:
American Indian Arabic Black East European East Indian Hispanic White Other

Sex:
Female Male

Vehicle License Plate Number:


Vehicle License Plate State:
AL AK AL AR AZ CA CN CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

Vehicle Identification Number:


Driver's License Number:


Fictitious Names, Alias, Married or Maiden:


Distinguishing marks, scars, tattoos, etc.:


Place of Employment, School, or General Hangout:


Telephone:
(XXX) XXX-XXXX
Fax:
(XXX) XXX-XXXX

E-Mail Address:
Invalid Email Address!

Physical Address:


City:


State:
AL AK AL AR AZ CA CN CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

Zip Code:
Invalid Zip Code!

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Additional Information

Is there additional information not already entered?
YesNo

* Summary as to why this is fraud:
Enter Summary!

Are you willing to submit additional information if it becomes available to you?
YesNo

Is this information additional to a tip previously submitted?
YesNo

If Yes, please enter Prior Tip Number:




For additional security, please check the checkbox below (and complete any puzzle prompts you may receive).