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Whistle Blowing Form
Whistle Blower Indentity
Do not complete this section if you wish to remain anonymous
Name
Department / Branch
Telephone
Email
Suspect Indentity
Name
Department / Branch
Telephone
Email
Identity of witness(es) (if any)
Do not complete this section if you wish to remain anonymous
Name
Department / Branch
Telephone
Email
Briefly describe the fault / malfunction / inappropriate activity etc ... and how you are informed. Specify what, who, when, where and how. If there is more than one claim, complete Section 8. Other Comments.
1. What are the malfunctions / faults detected ?
- Select -
Abuse of corporate assets
Conflict of interest
Corruption or attempted corruption
Deficiencies in the processing of personal data
Dishonest stock exchange transactions
Embezzlement
Falsification of accounting records
Financing of political activities
Gifts and unduly perceived benefits
Insider trading
Intentional concealment or misrepresentation of important data or facts
Market manipulation
Money laundering
Moral Harassment
Racial / ethnic / sexual discrimination
Sexual Harassment
Unfair competition
Unfair employment practices
Use of confidential information for personal purposes
Other breach of the code of ethics and professional conduct
Other cases or attempted fraud
2. Who committed the dysfunction / fault ?
3. When
3.1 On what date did the event take place ?
3.2 When did you notice it ?
4. Where
4.1 Where did the incident take place?
At the Head office
At the residence of a staff
In one of BOA branches
In one of the department
In the premises of a client
Other
Other place
4.2 Other details about the place
5. Is there any evidence you could provide us with ?
No
Yes
Choose a file
6. Are there any other stakeholders other than the mentioned suspect ?
No
Yes
Other stakeholders other than the mentioned suspect
7. Do you have any other details or information that could help us in our investigations ?
No
Yes
Other details or information
Declaration on honor
I declare that I am acting within the framework of the ethical alert right and that all the information given in this form is accurate
Submit
