PanPages Whistle-blowing E-form
Please fill all the fields marked with (*). In the event the information is not available at the time the case is lodged, please type 'Not Available' in the field.
In order for us to conduct a thorough investigation, please provide information as accurate as possible.
Anonymous complaint will not be entertained.
A: Personal Particulars of Whistle-blower
Name
Your answer
IC No. / Staff No.
Your answer
Correspondence Address
Your answer
Telephone No. (Home)
Your answer
Telephone No. (Office)
Your answer
Telephone No. (Mobile)
Your answer
E mail Address
Your answer
Designation / Occupation
Your answer
Preferred Communication Method
B: Information of PanPages Berhad Employee(s) Involved in Improper Conduct
Individual 1
Name of PanPages employee
Your answer
Designation of PanPages employee
Your answer
Individual 2
Name of PanPages employee
Your answer
Designation of PanPages employee
Your answer
Individual 3
Name of PanPages employee
Your answer
Designation of PanPages employee
Your answer
C: Details of Improper Conduct
Date of Incident
MM
/
DD
/
YYYY
Time of Incident
Time
:
Location of Incident
Your answer
Details of Improper Conduct
Your answer
Details of Witnesses (if any)
Your answer
Any monetary value involved?
If yes, please indicate amount
Your answer
Supporting Documents (if any)
D: Declaration
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