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This information will remain CONFIDENTIAL. Your Name: Address:    City: State:     Zip Code:  Phone:   Fax:   E-Mail: Yes No May we pass your contact information on to the F.B.I. for verification of the information shared herein.  (The F.B.I will keep this confidential!)

  Bust A Phony

Please provide as much detail as possible about the individual you are reporting.

Name:     
Address:  
City:    State:    Zip: 

Phone Number (If known): 

Please describe any other means the F.B.I. may be able to use to make contact with this individual (place of employment, friends or other contacts, vets clubs, etc.)

YES NO	To your knowledge has this individual ever been seen WEARING a Medal of Honor?
YES NO	Do you or anyone you are aware of have any reason to believe that this individual is in posession of a Medal of Honor?
Yes NO	Are you aware of any news stories (print or broadcast and including newsletters from smaller organizations) in which this individual is identified as or presents himself as a Medal of Honor recipient?

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Thank you for doing your part in not only insuring the integrity of the Medal of Honor but in protecting the rich heritage that is stolen from ALL military veterans whenever someone misrepresents their military record.

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