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Kontra Daya Reporting Form
This form intends to help monitors in reporting election-related incidents and/or fraudulent acts during the May 13, 2019 mid-term election.

Privacy Policy Notice
This privacy policy notice describes how we collect, use, disclose, transfer, store, retain, or process information.

By answering this form, you give consent for Kontra Daya to process the data provided within the framework of the 2019 Philippine midterm elections. Kontra Daya will be the sole owner of the information collected, as well as all revisions and changes to the information. Your information will be used to respond to your concern. All information provided will be kept confidential and may be shared accordingly with our affiliate ministries for the purpose associated with this event and its related activities. It will not be shared with a third party, unless authorized by you or if necessary to respond to your concern. Your information will be retained as long as necessary to fulfill your concern. Unless you specifically ask us not to, your information may be used by Kontra Daya to contact you via email or short message service (SMS) in relation to the 2019 Philippine midterm elections and related activities associated with it. You may cause the revision, change or deletion of your information by contacting Kontra Daya, provided it will not in any way prohibit the fulfillment of agreed services accorded to your organization.

Location of Incident (Precinct Number/School/Voting Center/City/Municipality/Province) *
Date of Incident (if not May 13, 2019)
MM
/
DD
/
YYYY
Time of Incident *
Time
:
Type of Incident *
Required
Brief Narrative of the Incident *
Supporting Pictures/Video/Documents
Name *
Contact Number (for verification of report purposes only, if necessary) *
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