EBRD compliance report form

* indicates a required field

1. Personal Details (if you wish to remain anonymous go to section 2) 

First name
Surname
Address
City
State / Province
Postcode
Country
Telephone 1
Telephone 2
Include country and area codes.
Email
Ensure you've entered your email correctly.
2. Would you like to be contacted by us? 
  Yes No

If YES, please specify the most suitable means and time:
  Are you directly involved in the matters that you are reporting?

Yes No

If YES, Please describe your involvement:
  Would you like us to provide you with feedback?

YesNo

Please note that the confidential nature of reports may restrict disclosure of details of the investigation.

You may wish for your name to be kept confidential. In such case your name will not be disclosed without your consent and the information received will be handled in a way as not to disclose your identity to anyone not involved in the investigation.
  Do you wish for your name to be kept confidential?

Yes No

3 . The Report 

Project name
Country
Country this submission pertains to.
Time and date
Time Day/Month/Year of incident
  * What is the allegation about?
  * Description of the alleged facts
  * What are you basing your allegations on?
  * Will you be providing us with documents supporting this allegation?

YesNo
 
* Date of submission
 

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