22 Mar Whistle Blowing Policy Appendix I

Posted at 16:43h in Blog Post by
Whistle Blowing Policy
Appendix I
Appendix II

Whistleblowing Reporting Form

PART A To be completed by individual raising a concern
1. Details of Whistleblower
Name:
Contact no.:
Email:
2. Issue Raised:

 

  

 

 
Nature of the Concerns:  

 
Background, Date and History of the Concerns:

 
Identity of the Person Engaged in Improper Conduct:

 
Reasons for the Concerns:

 

  

 

 
Details of Evidence and Witnesses:

 

  

 

 
Whether Action Has Already Been Taken and By Whom:

 
Whether Whistle Blower Has Any Personal Interest in the Matter Reported:

 
Submitted by:

Name:

Date:

Time:

 Received by:

Name:

Date:

Time:
PART B To be completed by Investigator / Investigating Officer
3. Additional information

 
4. Investigation of Concern / Steps Taken to Address the Concern

 
5. Findings

 

 
6. Recommendations

 

 
7. Preventive Measures to be Taken

 

 
Prepared by:

Name:

Date:

Time: