Insurance Fraud Research Register Submission Form



Please answer the following questions as completely as possible. A sample of a completed "Insurance Fraud Research Register Submission Form" is available for your reference by clicking here. When you complete your answers to the questions, select the "Send comments" button. This will cause electronic mail to be automatically sent. If you are not using a "forms capable" world wide web client program, then we would be grateful if you could email the same information by clicking here.

Please enter your comments in the spaces provided below. Thank you in advance for your cooperation.

1) Author of item you are suggesting for submission to the IFRR:

2) Title of item you are suggesting for submission to the IFRR:

3) Sources where the above mentioned item can be located:
(Please include any information you have available. For example, volume, month, page numbers, etc. Also if there is more than one source, please list both.)

4) If you wish to submit an annotation for the submission item, please do so below:

5) Your name:

6) Your e-mail address: