Attachment E

Surname:

Investigation  Case No:

Given Names:

Claim/Service Provider No

(N/A if Staff Member)::

Recoveries:-

External Costs :-

Internal Costs:-

Case Result:-

Unsubstantiated, Inconclusive, Resolved by admin. action,

Guilty - (a) conviction, (b) no conviction recorded, (c) good behaviour bond, (d) community service, (e) Probation, (f) Fined, (g) Imprisoned

Not Guilty

Benefits ceased

Not proceeded with