Whistle Blower Policy - Page 6

Annexure 1: Template for Reporting Violation

To: Redressal Committee: ________________________________________

Violation details:

  1. Which aspects of the whistle blower policy have been violated?
  2. Who is /are the individual/ people/ functions involved?

Critical Incidents and Factual Data:

  1. Please describe what constitutes the violation i.e. incident details.
  2. List supporting information/ data that you would have, that the Committee can seek from you while investigating.

Date: ________________________________________

Location: ________________________________________

Name of the Person reporting (optional): ________________________________________

Contact Information (including email optional): ________________________________________

Note: ________________________________________

Reporting done by individuals disclosing their names will be attended to first. Anonymous complaints are discouraged and would be considered only in extreme cases.

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