Modern Slavery Reporting Form

Use this form to report suspected or actual modern slavery in Blayney Shire Council’s supply chain or operations, or within our community. The information you provide will be reviewed by Council and the appropriate action determined. Our Modern Slavery Prevention Policy and other fact sheets which are available, can help you to determine whether your concerns are within the definition of modern slavery.

All concerns of risks of modern slavery within Council’s supply chain must be reported here, or to a member of staff of Blayney Shire Council. This online form enables you to remain anonymous if you wish to do so.

Privacy Protection Notice

This information being collected to investigate report of suspected modern slavery, acknowledge reports, and if required, to follow up or seek further information.
This information is being collected for Blayney Shire Council employees.
The provision of this information is done so voluntarily.
Blayney Shire Council will use this information for the purposes it was collected, and it may be necessary to use for the exercise of other functions. Other uses may include reporting suspected modern slavery to external investigating authorities, such as the Fair Work Ombudsman, Safe Work NSW, NSW Police, the Australian Federal Police and the NSW Anti-slavery Commissioner.

Are you reporting as:

I am (select one)

Provide name(s), job title(s), company name(s) of those involved in the suspected modern slavery and the nature of their involvement

Provide an outline of the issue of concerns, including the circumstance of modern slavery.*- required

How does the above relate to Blayney Shire Council supply chain or operations?

Provide the name(s), job title(s), company name(s) of those involved in the suspected modern slavery, and the nature of their involvement.

Are there any urgent safety concerns?

Have you previously reported this issue to Blayney Shire Council?

Do you wish to provide your personal details? Providing your details will assist us with any follow up actions that may be required.

Your name

First NameLast Name

Email

example@example.com

Mobile Phone Number

Please enter a valid phone number.Format: 0000 000 000.

Do you have any supporting evidence or documents to upload?

Privacy Statement

Personal information supplied to or collected by Blayney Shire Council will only be stored and processed by Council for lawful purposes directly related to the functions and activities of Council. Any personal information supplied will only be disclosed to a third party for the purpose of performing a lawful function or activity and for no other purpose. Disclosure of personal information to a third party will be in accordance with Council’s Privacy Management Plan found at: https://www.blayney.nsw.gov.au/council/council-information/council-policies