Follow the steps to fill out the form correctly

1. Click ‘Get Form’ button to obtain the form and open it for completion.
2. Enter today's date in the designated field at the top of the form.
3. In the 'Possible Fraud and/or Abuse Committed by' section, identify the individual or entity you believe is involved by selecting the appropriate option.
4. If you choose 'Other,' please specify the person or business's name and provide their address and location.
5. Optional: Fill in your details as the person completing the form. If you do not wish to provide your name, you may leave this section blank.
6. Enter a telephone number where you can be reached, and if applicable, the WIC ID number of the individual involved.
7. In the 'Issue' section, select from the given list the type of fraud or abuse that has taken place, or specify another issue if necessary.
8. Provide a detailed description of the issue in the 'Describe issue' section. Clearly outline your concerns for thorough understanding.
9. Once all sections are completed, review your responses for accuracy to ensure the form is properly filled out.
10. After finalizing the form, click the 'Submit' button to send it electronically, or choose to print and either mail or fax it to the Maryland WIC Program.

Complete your documents online today to ensure your important information is submitted efficiently.