Confidential Fraud Reporting
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EthiCall Report Form
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If you wish to report an incident anonymously, please leave identifying fields blank.
Your Name (Optional)
First
Last
Your Phone (Optional)
Your Email (Optional)
Organization Code
*
BSC100
KCI100
LAP100
QTV100
SCO100
SEC100
XOM100
Branch / Location Description
Category
*
Select One
Company Policy Violation
Internal Corruption and Fraud
Customer Fraud
Vendor Fraud
Competitor Interaction
Misuse of Assets
Other
Date of Incident
*
MM slash DD slash YYYY
Where did the incident(s) occur?
*
Parties Involved
*
Incident Narrative
*
When providing the narrative below, please include as many details as possible (names, dates, times, et cetera)
Have you informed management?
*
Yes
No
If yes, whom in management did you inform?
Have you tried to resolve the problem?
*
Yes
No
Have you reported this incident elsewhere?
*
Yes
No
If yes, to whom?
Do you have any supporting documentation on this claim?
Yes
No
If yes, describe the documentation:
Upload Additional Evidence
Accepted file types: jpg, png, pdf, doc, docx, xls, xlsx, Max. file size: 50 MB.
You may upload evidence as needed. (.jpg, .png, .pdf, .doc, .docx, .xls, .xlsx only)
Email
This field is for validation purposes and should be left unchanged.
