WHISTLEBLOWING E-FORM Whistle Blower DetailsCategory *Categoryselect oneStaffNon-StaffNameEmail AddressPhoneDo you wish to remain anonymous? *Do you wish to remain anonymous?select oneYesNoAre you willing to be a witness in any disciplinary or other proceedings? *Are you willing to be a witness in any disciplinary or other proceedings?select oneYesNoNamePositionCompanyCompanyselect oneAir Selangor Holdings BerhadAIS Management Services Sdn BhdAIS Small Hydro Sdn BhdCubiq Meters Sdn BhdHeliosel Sdn BhdHow do you know this Employee?NamePositionCompanyCompanyselect oneAir Selangor Holdings BerhadAIS Management Services Sdn BhdAIS Small Hydro Sdn BhdCubiq Meters Sdn BhdHeliosel Sdn BhdHow do you know this Employee?Complaint DetailsComplaint Type *Complaint Typeselect oneBribery & KickbacksFalsifying ClaimsAbuse of PowerViolation of Code of Conduct & Business EthicsOthersIncident DateIncident LocationHow did you know or suspect that there was an irregularity?DetailsWitness (if any)Photo Evidence (if any)Choose FileNo file chosenDelete uploaded fileHave you lodged this complaint with another person, department, or authority before?Have you lodged this complaint with another person, department, or authority before?select oneYesNoif YESIf YESselect oneImmigration Department of MalaysiaMalaysia Anti-Corruption CommissionRoad Transport Department MalaysiaRoyal Malaysia CustomsRoyal Malaysia PoliceSecurities Commission MalaysiaOthersAttach a copy of the reportChoose FileNo file chosenDelete uploaded fileDate the report was madeStatus of the reportDeclarationConsent * I certify that all information and statement provided above are valid to the best of my knowledge, information, and belief. I agree that the information provided is to be used and processed for investigation purposes and may be forwarded to a department, authority, or enforcement agency. I understand that if there is false and incomplete information, and I am uncontactable by the appointed authorised personnel of the Company to further clarify the information, this complaint will be null and void. Send Message