GWK - Confidential Incident Form

REPORT FRAUD

CONFIDENTIAL INCIDENT FORM

If you agree to submit a confidential report, you agree to the confidential disclosure of your personal details and you will be prompted to enter your name and contact details. Your report and personal information will be handled in a confidential manner and will not be disclosed or discussed with any person other than those with a legitimate right to such information. Feedback will be provided to you where appropriate and required.

General Information

Name

Surname

Contact Number

Email

Where are you employed?

What would be the most convenient time to contact you?

Preferred contact method?

Incident Details

In which city/town did the incident take place?

In which division/department/business unit did the incident take place?

Date of incident

Person(s)/organisation(s) involved?

Nature of allegation

Description of the incident

Is management aware of the incident?

Yes

Would you like to attach any documents (proof)?

Choose file No file chosen