Complaint/Whistleblowing Form

Gender: * Male Female

Is the person submitting this:*  Employee AlBaraka Customer Vendor Other

First name: *

Last name: *

Telephone:

Mobile: *

Email: *

Communication preference: Mobile Email Telephone

Address line one:

Address line two:

City:

Country:

Specify whether your complain is on: * AlBaraka employee AlBaraka service Other

How many times has this incident taken place (if applicable):

How long this incident been taken place (if applicable):

Would you like to arrange a meeting / telephone call with an Investigating Officer to discuss this matter: Yes No

Brief your incident/complaint/issue: *

How do you want the business to put things right for you? And/or what type of resolution you would like to see in this matter? *

Disclaimer

I confirm all the information I have given is true and accurate to the best of my knowledge. I understand that:

• AIB will need to handle personal details about me – which could include sensitive information to deal with my complaint effectively.
• AIB may need to share information about my complaint and any records pertinent to this request with the business I have complained with, and/or with other relevant organizations.
• AIB may publish examples of where things can go wrong, based on real cases, but AIB will always respect my privacy and keep my personal information confidential.

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