Make a Request to Client Affairs

Your contact information

(This section may be left blank if you wish to remain anonymous. However, we recommend that you share your contact details so that, if necessary, we may seek additional information from you during our investigation process. Please note that all sections marked with an * below are mandatory).

Reference No. (system generated number):

Reference No

Subject(s) information

(The person(s)/company in respect of whom/which you are submitting this report)

Witness(es) information

(Information of any other person(s) who has/have information relating to the reported misconduct)

Details of the misconduct you are reporting

(Describe the misconduct and how you came to know about it. If you wish to report more than one allegation, please number each allegation in the text box below.)

If it was reported, please provide *

Was it reported verbally or in writing (if in writing, please provide a copy using the document upload button below)

Upload Document

Is there any individual who is conflicted by the misconduct and who should not be assisting in reviewing or assessing the alleged misconduct? *

Yes No

Were any internal controls to prevent the alleged misconduct circumvented? If yes, what controls were circumvented and how were they circumvented? *

Yes No

Attachment 1

Attachment 2

Attachment 3

Declaration

I declare that all of the information provided by me in this form is, to the best of my knowledge and belief, true and correct and that all documents provided (if any) are true and accurate copies of the originals. I understand and agree that the QFC Authority will use the information provided in this form to investigate the matter(s) reported in accordance with the applicable regulations, rules, policies, and procedures. By clicking the “Submit” button below, I consent to the processing by the QFC Authority of my personal information set out in this report.

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Whistleblowing Reporting Form

Your contact information

Subject(s) information

Witness(es) information

Details of the misconduct you are reporting

Attachments

Declaration

Whistleblowing Reporting Form

Your contact information

Subject(s) information

Witness(es) information

Details of the misconduct you are reporting

Attachments

Declaration

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