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* 1. Reporter’s contact information

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* 2. Suspect’s information

*About the misconduct/ improper activity

Complaint (Briefly describe the misconduct/ improper activity and how you know about
it. Specify what, who, when, where and how. If there is more than one allegation, number
each allegation):

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* 3. What misconduct/ improper activity occurred?

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* 4. Who committed the misconduct/ improper activity?

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* 5. When did it happen and when did you notice it?

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* 6. Where did it happen?

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* 7. Is there any evidence that you could provide us?

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* 8. Are there any other parties involved other than the suspect stated above?

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* 9. Do you have any other details or information which would assist us in the investigation?

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 10. Any other comments?

Note: * You SHOULD NOT attempt to obtain evidence for which you do not have a right of access
since whistleblowers are ‘reporting parties’ and NOT ‘investigators’.
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