Reporting form

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    REPORTING FORM
    for breaches of the law and / or internal regulations

    DATA OF THE REPORTING PERSON

    1.
    2.
    3.
    Contact methods:
    Email:
    Phone:
    By post, to the address:
    I do not wish to be contacted
    Reports on breaches of the law and/ or internal regulations can be made nominally or anonymously:
    • - In the case of a nominal report there is the possibility to communicate between the reporting person and the designated person in order to clarify certain aspects included in the report;
    • - The person who reports anonymously and does not provide contact data or does not wish to be contacted will not be able to be informed about the registration of the report, its progress, or the method of settlement.

    INFORMATION ABOUT THE REPORT

    4.
    5.
    6.
    7.
    8.
    9.
    10.
    I CONSENT TO the processing of my personal data, in accordance with the Regulation (EU) 2016/679 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data.
    YESNO
    I CONSENT TO the disclosure of my identity to other persons except the designated persons, if this is necessary for the investigation of the reporting.
    YESNO
    Date:
    Signature (optional):
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