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Mandatory Federal Acquisition Regulation Contractor Disclosure Form

Submit the Form Online
Mail the Form
Upload a Pre-Filled Out Form

The purpose of this mandatory Federal Acquisition Regulation (FAR) disclosure form is to afford contractors a means to fulfill their obligation to notify the NASA Office of Inspector General (OIG) of any credible evidence that a principal, employee, agent, or subcontractor of the contractor has committed a violation of the civil False Claims Act or a violation of federal criminal law in connection with the award or performance of a contract or any related subcontract. The individual completing this form must be a director, an officer, an employee, or an independent contractor authorized to act on behalf of the organization for which this disclosure form is filed. If the information you wish to disclose does not fall within these guidelines, please refer to the OIG hotline form.

All submissions must be in writing. You may submit disclosures in several different ways: filling out the online form below, uploading a pre-filled out form, or hand-delivering a hard copy. Submitting information via the OIG hotline will not fulfill the mandatory disclosure requirements.

If you have questions or are unsure if this form applies to you, please contact the Counsel to the Inspector General at HQ-OIG-Counsel@mail.nasa.gov.

Submit the Form Online

Fill out the fields below to submit an online FAR disclosure form.

Contact Information

Name(Required)
Email address(Required)
Address(Required)

Relationship

My company is the:
I am reporting on the:(Required)

Contract Information

Contract officer's name

Incident Details

MM slash DD slash YYYY
Which of the following best describes the reason for reporting this matter (check both if applicable)
Please provide a complete description of the facts and circumstances surrounding the reported incident, including names of individuals involved, dates, locations, how the matter was discovered, potential witnesses and their involvement, estimated monetary loss to the United States, and any corrective action taken by the company.
Please include any supporting files or documents.
Drop files here or
Accepted file types: jpg, gif, png, heic, pdf, doc, docx, xls, xlsx, Max. file size: 15 MB, Max. files: 8.

    Notice

    Submission of willful false statement may violate 18 USC 1001.
    This field is for validation purposes and should be left unchanged.

    Upload a Pre-Filled Out Form

    If you have already filled out a FAR disclosure form, you may upload it here instead of submitting the online form above.

    Drop files here or
    Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 15 MB, Max. files: 3.
      This field is for validation purposes and should be left unchanged.

      Mail the Form

      To mail or hand-deliver a hard copy of your FAR disclosure form, please use the following address:

      NASA Office of Inspector General
      PO Box 23089
      L’Enfant Plaza Station
      Washington, D.C. 20026