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JCVA Speak Up Reporting Form
JCVA is committed to conducting business according to the highest ethical and legal standards. This channel is for reporting actual or suspected violations of Company policies, the Code of Conduct, unlawful acts, or risks to the Company or to health and safety, under our Speak Up (Anti-Retaliation) Policy. All reports are treated as strictly confidential. JCVA prohibits retaliation against anyone who reports in good faith. You may submit this report anonymously.
1. Do you wish to identify yourself?
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I will identify myself
I wish to remain anonymous
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About You
You may identify yourself or remain anonymous. Both are accepted.
2. Full name
3. Your relationship to JCVA
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Employee
Third-party service provider personnel
OJT or trainee
Business partner
Client
Other stakeholder
4. Contact details for follow-up (email or mobile)
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The Concern
Provide as much detail as you can. Specific dates, names, and documents help us act quickly.
5. Category of concern
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Fraud, theft, or financial irregularity
Corruption or bribery
Conflict of interest
Harassment or discrimination
Health and safety risk
Data privacy breach
Violation of Company policy or Code of Conduct
Retaliation for a prior report
Other
6. Who is involved? Provide names and positions if known, or descriptions if not.
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7. When did this happen, or when did you discover it? Indicate if it is ongoing.
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8. Where did it happen?
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JCVA office
Project site
Client premises
Online or via communications
Other
9. Describe what happened. Include how the act was committed or discovered, and which rule or policy you believe was violated, if known.
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10. Were there witnesses? If yes, who?
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Evidence and Prior Reporting
11. Do you have supporting evidence such as documents, photos, or messages?
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Yes, I will upload the evidence
Yes, but I prefer to describe it
No
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12. Describe the evidence you hold.
13. Have you previously raised this concern with your immediate superior or anyone at JCVA? What was the outcome?
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14. Is there risk of imminent harm, continuing loss, or destruction of evidence?
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Yes
No
15. If yes, briefly explain the urgency.
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Declarations
16. Does your concern involve the Chief Operating Officer, the Chief of Staff, or the Head of the People Support and Culture Department?
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Yes
No
17. Good-faith declaration
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I confirm that this report is made in good faith and that I reasonably believe the information provided is true.
18. Privacy acknowledgment
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I understand that the personal information in this report will be processed in accordance with the Data Privacy Act of 2012 (RA 10173) solely for the purpose of receiving, assessing, and investigating this report. Access is restricted to authorized recipients under the Speak Up Policy, and records will be retained only as long as necessary for investigation and compliance purposes.
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