Date of application*
Name
Position
Workplace / Organizational Cell
Phone
E-mail address
Date of occurrence of notification
Indication of which regulations the notification concerns*
Description of the subject of the violation*.
Describe in detail the circumstances and how knowledge of it was obtained, including persons relevant to its occurrence, indications of time and place, identification of potential witnesses (including persons contacted by the reporting party, other relevant to the case):
Indication of evidence for the case*
Attach files
Maximum of 5 files, total 10 Mb, jpg, gif, png, pdf, doc, docx, odt
Potential witnesses to irregularities
Name of the witness, position, place of work / organizational unit
Declaration by the submitter* I declare that by making this submission:
I'm acting in good faith, not for profit,
I have a reasonable belief that the allegations contained in the disclosed information are true,
The information disclosed is true to the best of my knowledge and I disclose all facts and circumstances known to me concerning the subject matter of the application,
I am aware that a person who has suffered damage due to a whistleblower knowingly reporting false information is entitled to compensation or damages for violation of personal rights from the whistleblower who made such a report.
Yes, I declare
