Step 1: Particulars of Whistleblower
Note: As much as we respect anonymity, we encourage you to provide your contact details such as email address or contact number (that are not identifiable to you) so that we can maintain communication with you, if necessary. Nevertheless, you may leave this section blank if you wish to remain anonymous.
Name
I wish to remain anonymous
Company
Contact Number
Preferred Method of Communication
Step 2: Particulars of person(s) involved / suspected to be involved
Please state names of all individuals involved.
Name*
Designation*
Company/Department*
Step 3: Complaint Details
Type of Misconduct*
When Did It Happen?*
What Time Did It Happen?*
Where Did It Happen?*
Incident Details*
Briefly describe the misconduct/improper activity and approximate amount if it involves a monetary sum.
How did you become aware of the alleged improper activity?*
Please provide any additional details of the incident that would be useful to our investigators. (Optional)
Supporting Evidence
Please attach any evidence e.g. screenshots, voice recordings, video recordings, documents and/or photos which support your allegation.
Have you raised your concern on this matter to another person / department/ authority before?*
Yes
No
Step 4: Declaration
I declare that all information provided in this Form is made in good faith, voluntarily and is true, correct and complete to the best of my knowledge, information and belief.
I hereby agree that the information provided herein to be used and processed for investigation purposes and further agree that the information provided herein may be forwarded to another department / authority / enforcement agency for purposes of investigation.
