WHISTLEBLOWING FORM

Download Whistleblowing Form (pdf)

Please fill up the Whistleblowing Form and submit supporting documents (if any) using one of the following reporting channels:

Email to whistleblowing@suriaklcc.com.my;
Mail to Suria KLCC Sdn. Bhd., Integrity & Compliance Department, Level 13 Menara Darussalam, 12, Jalan Pinang, 50450, Kuala Lumpur;
In person to respective Head of Department, Head of Human Resource or Head of Integrity & Compliance.

For online submission, please complete the Whistleblowing e-Form below.

WHISTLEBLOWING e-FORM

Please provide sufficient information as accurate as possible to assist us in the Investigation of your disclosure.
A. WHISTLEBLOWER IDENTITY
Name
(You may choose to be anonymous, but you are encouraged to disclose your identity)
Email Address*
Telephone/Mobile No.*
Employee ID No.
(For SURIA KLCC employees only)
Position/Department
(For SURIA KLCC employees only)
B. IDENTITY OF THE PERSON(S) INVOLVED IN THE SUSPECTED OR KNOWN IMPROPER CONDUCT
(Click '+' at the right of the form to add name)
Name Position Department Company

(Click '+' at the right of the form to add name)
C. PARTICULARS OF THE SUSPECTED OR KNOWN IMPROPER CONDUCT
Date of Event*
MM slash DD slash YYYY
Time of Event*

: Hours

Minutes

AM/PM
Venue and Place of Event*
Details of suspected or known improper conduct*
Please provide supporting documents such as photos, scanned documents, video and audio recordings (if available) to assist us in the Investigation, if any. (Up to 5 files totalling 10 MB can be uploaded)
Drop files here or

Max. file size: 64 MB, Max. files: 5.
Other Information (if any)
Note:
1. All fields marked with an asterisk (*) are mandatory to fill in.
2. If space given is insufficient, please submit the details in a separate document as attachment.
D. DECLARATION OF THE WHISTLEBLOWER
*
- I hereby declare that all information given herein is made in good faith and voluntarily to the best of my knowledge and I will ensure that my participation in this matter will be kept confidential. I do understand that SURIA KLCC will use the information, document and material provided throughout the investigation process.
- I fully understand that by signing this Form, I will be entitled to whistleblower protection from the SURIA KLCC as set out in SURIA KLCC’s Whistleblowing Procedures and Policy and the Whistleblower Protection Act 2010. I also fully understand that in the event I have made this disclosure maliciously or in bad faith, the whistleblower protection stated in SURIA KLCC’s Whistleblowing Policy and the Whistleblower Protection Act 2010 will not be applicable to me.
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Name	Position	Department	Company

Whistleblowing e-Form

WHISTLEBLOWING FORM

WHISTLEBLOWING e-FORM

A. WHISTLEBLOWER IDENTITY

B. IDENTITY OF THE PERSON(S) INVOLVED IN THE SUSPECTED OR KNOWN IMPROPER CONDUCT

C. PARTICULARS OF THE SUSPECTED OR KNOWN IMPROPER CONDUCT

D. DECLARATION OF THE WHISTLEBLOWER

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