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Name & Contact Information
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Phone Number (Preferred)
Include the area code, extension, and/or dialing codes if applicable.
Name & Contact Information
Employee Former Employee Vendor Contractor Supplier Agent Spouse/Relative of Employee Other
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Phone Number (Preferred)
Include the area code, extension, and/or dialing codes if applicable.
Location of Incident/Event
Click the button labeled Look-Up to locate and select a location. If the location you are looking for is not available, select the location labeled Other / Not Listed , and then enter the location information in the form manually.
Issue One
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Select the type of issue that best represents the incident. Abuse of Authority (inappropriate supervisory directions) Account and Investment Reviews Accounting Irregularities and other Accounting, Internal Accounting Controls or Auditing Matters Alcohol/Drug/Substance Abuse in Workplace Bribery or Kickbacks (nongovernmental) Business Practices (major deficiencies) Business Practices (policy and/or procedural issues) Business Relationships with Clients, Suppliers and Vendors Client Assets Client Disclosures and Records Client Information and Data Protection (includes lost or compromised records and privacy matters) Company Name and Brand Conflicts of Interest (between clients, suppliers and vendors, not between employees) Discrimination, Harassment, Equal Employment or Diversity Issues Employee Background Checks Employee Disputes Escheat and Unclaimed Property Failure to Report a Violation of Code, Policy/Procedure, Law or Regulation Fair Competition, Antitrust and Antiboycott Matters Foreign Corrupt Practices Act and Improper Payments Fraud or Illegal Activities Gifts and Entertainment Government Contracts (including gifts & entertainment) Information Systems Insider Trading Intellectual Property/Copyright Issues Inter-affiliate Agreements/Credit Extensions Lobbying Activities Media or Public Relations Money Laundering, Terrorist Financing, Know Your Customer Matters and OFAC Outside Affiliations (board or officer positions) Outside Employment and Compensation (including ownership in other businesses) Personal Fiduciary Appointments and Bequests Personal Relationships Personal Securities Trading (excludes trading on material, nonpublic information) Physical Assets Physical Threats or Violence Political Activities and Contributions (Personal and Organizational) Procurement and Purchasing Practices Professional License Proprietary or Confidential Information Records Management and Record Keeping Relationships with Clients, Suppliers or Vendors Retaliation Safety Sales, Marketing and Advertising Practices Securities Valuation Tax Issues Theft Other Inquiry
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Description
No type of issue or event selected.
Date
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Approximate date of issue/incident.
Details
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Provide all details regarding the alleged violation, including the locations of witnesses and any other information that could be valuable in the evaluation and ultimate resolution of this situation.
Inquiry
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Provide the details of your inquiry/question.
Action Taken
Personnel action Advice given (no escalation required) Referred to another resource Duplicate report (issue previously escalated/resolved) Other
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Substantiated Unsubstantiated Frivolous Insufficient Information Referred
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