Whistleblower Disclosure Form
Simba Global and our staff are committed to providing services safely and honestly. We expect everyone to comply with all legal requirements. We will support and respect anyone who acts as a whistle-blower to draw attention to fraud, suspected inappropriate, corrupt, or illegal conduct or behavior. To report any incident, please provide the following information
Anonymous Submission
Yes
No
Date and time when incident occurred:
*
-
Month
-
Day
Year
Date
24Hour Minutes
Full Name
Please enter your full name if you wish to provide it.
Preferred Contact Method
Email
Phone
None
Email
Please provide a valid email address if you wish to be contacted regarding your report.
Phone
Provide a contact number if you prefer to discuss the report by phone
Report Type
*
Please Select
Safety Concern
Fraud
Harassment
Other
Incident Location (Please provide specific details):
*
(e.g., office location)
Summary of Incident
*
(Briefly describe the incident/issue you're reporting)
Detailed Report
*
Provide as much detail as possible, including names of those involved, dates, etc
Supporting Evidence
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Confidentiality Agreement
*
I acknowledge that this report will be treated confidentially and understand that unauthorized disclosures may affect the investigation.
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