Workplace Sexual Harassment Complaint Form

 

I'm sharing a Workplace Sexual Harassment Complaint Form, which can be a valuable resource for those who have experienced or witnessed any form of sexual harassment in their workplace. This form is a tool to help individuals come forward, share their experiences, and seek support when needed.

By sharing this form, I hope to encourage open dialogues and emphasize the importance of addressing workplace harassment promptly and effectively. It's crucial to remember that silence perpetuates such behavior, and together, we can break the cycle.

Whether you're an employee, manager, or business owner, let's pledge to create workplaces where every person feels safe, respected, and heard. Remember, it's not just about complying with the law; it's about fostering a culture of respect and equality.

Let's stand together to make our workplaces safer and more inclusive for all. Share this form, spread awareness, and let's make a difference together. 💪

#WorkplaceHarassment #EqualityAtWork #SpeakUp #SafeWorkplace

Workplace Sexual Harassment Complaint Form

 

[Date of Complaint Submission: Insert Date]

 

Complainant Information

- Name of the Complainant: [Your Full Name]

- Designation: [Your Job Title]

- Function/Department: [Your Department/Division]

 

Respondent Information

- Name of the Respondent: [Full Name of the Accused]

- Designation: [Accused's Job Title]

- Function/Department: [Accused's Department/Division]

- Name of the Company (if the Respondent is from a different workplace): [Name of the Company, if applicable]

 

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Date of the Incident (or Recent Occurrence in Case of Repeated Incidents):

- [Date of the Incident/Recent Occurrence]

 

Details of the Complaint/Incident (Provide as much detail as necessary):

 

[Describe the incident(s) and any relevant information in detail.]

 

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Witnesses (if any):

(Note: Please provide names, designations, functions, and workplaces of any witnesses from your side who can support your complaint. The Internal Committee (IC) may contact them during the inquiry.)

 

1. Name of Witness 1: [Full Name]

   - Designation: [Witness 1's Job Title]

   - Function/Department: [Witness 1's Department/Division]

   - Workplace (if not from the same company): [Witness 1's Workplace, if applicable]

 

2. Name of Witness 2: [Full Name]

   - Designation: [Witness 2's Job Title]

   - Function/Department: [Witness 2's Department/Division]

   - Workplace (if not from the same company): [Witness 2's Workplace, if applicable]

 

[Add more witnesses as necessary.]

 

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Evidence (if available):

(Note: Any evidence you have or would like to present to support your complaint can be mentioned here. Please be aware that the absence of evidence does not invalidate your complaint, but providing any available evidence will assist the IC in assessing your complaint. Examples of evidence include text messages, WhatsApp messages, videos, audio recordings, emails, or any other relevant documents or materials.)

 

[Describe any evidence you may have or intend to provide.]

 

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Any Additional Information (to Support Your Complaint):

 

[Include any other pertinent information that you believe is important for the IC to consider while reviewing your complaint.]

 

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Complainant's Name and Signature (if submitting a hard copy):

 

[Your Full Name and Signature, if applicable]