Complaint form

Complaint form

COMPLAINT TO THE INTERNAL COMMITTEE - [Company name]

Date of complaint: [date]

Complainant
Name: [name]   Employee ID: [id]   Department: [department]
Contact: [phone / email]

Respondent
Name: [name]   Designation: [designation]   Department: [department]

Incident(s)
Date(s) and time(s): [details]
Place: [place or platform]
What happened: [describe in your own words]
Witnesses (if any): [names]
Documents or messages attached: [list]

Previous complaint about this matter: [yes / no]

Support needed: [for example, change of seat or reporting line during the inquiry]

Signature: ______________   Date: ____________

Received by (IC member): ______________   Date: ____________

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