Signaller

Report Violation of Law

Subject

1. Information about injured person * if applicable

2. If applicable Information about the person whose actions or omissions are the subject of the report *in the case of a report concerning several people, please enter all of them, name, surname, position.

3. What violation of the law are you reporting? *Examples of violations of the law are indicated in the procedure.

4. What are or have been the violations of the law that you report?

5. When and where did the reported violations of the law take place?

6. How did the violation of the law occur and for what reason?

7. Do you wish to include evidence, if so, please attach it below.

8. Is this the first time you have reported this violation of the law, or you have made such report before? Have you received a response?

9. Is there anything else you want to add to this form?

Attachments (maximum 10)

Name and surname

Captcha