Report Violation


DATE :

REPORTERS INFORMATION : (Name of person who is reporting the violation)
Name :

Designation :

Company Name :

Contact Number :

Email id :

SUSPECTS INFORMATION : (Name of the person against whom the violation is being reported)
Name* :

Company Name :

Designation :

Department :

WITNESSES INFORMATION (IF ANY)
Name :

Designation :

Department :

Contact Number :

Email id :

COMPLAINT DETAILS :
You are requested to provide as many details as possible so that we can investigate your complaint thoroughly. Help us to help you.
1 What was the misconduct/violation occurred ? *
(Please mention nature of the misconduct/violation)

2 When did it happen?*
(Please mention dates/time if you can, or if the same is ongoing kindly mention the same)

3 When did you notice it?*
(Please mention the date/time , duration (eg: a week ago, a month ago etc)

4 Where did it happen?*
(Please mention the location (i.e. address of the Alcon office where the incident/violation has occurred, if the location is external please do mention the same)

5 Is there any proof that you can provide ?* Yes No

6 Are there any other parties involved in addition to the suspect stated above?
(If yes please provide their details in this space)
7 Any other information that you would like to provide which would help in resolving your complaint?

I , hereby confirm that all the information provided above is true to the best of my belief. I also hereby confirm that I am filing this report in the best interests of the company and without any intention of maligning the person named as a suspect in the above report.
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