Whistle Blowing Form | Complaint platform

Whistle Blower Indentity

Do not complete this section if you wish to remain anonymous

Name

Department / Branch

Telephone

Suspect Indentity

Name

Department / Branch

Telephone

Identity of witness(es) (if any)

Do not complete this section if you wish to remain anonymous

Name

Department / Branch

Telephone

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 ?

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?

Other place

4.2 Other details about the place

5. Is there any evidence you could provide us with ?

Yes

Choose a file

6. Are there any other stakeholders other than the mentioned suspect ?

Yes

Other stakeholders other than the mentioned suspect

7. Do you have any other details or information that could help us in our investigations ?

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

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