1. (a) the names, case number and other identifying information;
2. (b) a brief description of the facts constituting the grounds for suspecting fraud;
3. (c) the estimated amount of overpayment;
4. (d) the duration of such overpayment;

5. (e) whether the case was referred to the appropriate district attorney or other prosecuting official:

   1. (1) if a case is not referred, the reasons for such action shall be stated;

   2. (2) if a case is referred, the record shall include:

      1. (i) date of such referral;
      2. (ii) disposition of such referral; and
      3. (iii) the amount of any sum of money recovered.

Each local social services department shall keep a record of all cases referred to the designated person or unit for review, which record shall include: