Home

  
  

Home

 
   
eHR Ethics Complaint

Please fill in the following information. If there is more than one Respondent, please complete a form for each one. Complaints must be filed against an individual, not a company/corporation. NOTE - The ERC cannot consider anonymous complaints. If you file an anonymous complaint, it will automatically be rejected. If your complaint involves a chapter dispute/conflict, please refer to the Chapter Conflict Resolution Program.

  
Complainant(s) Information - Complaint cannot be filed anonymously

Your Name
Your Address
Daytime Phone
Evening Phone
Your Email Address
  Information regarding individual against whom the Complaint is filed (the "Respondent"). NOTE - The Respondent must be an individual, not a company/corporation. If your complaint involves a chapter dispute/conflict, please refer to the Chapter Conflict Resolution Program.
Respondent Name
Respondent Address
Respondent Phone Daytime
Resplondent Phone Evening
Respondent Email Address
Respondent Association
 


Complaint details
Provide a statement of what you consider to be the essential facts involved in the alleged ethics violation. While not mandatory, HR requests that you include specifically the applicable section(s) of the Company Code of Ethics and Professional Conduct you believe to have been violated. (Note that that the HR will only consider alleged violations of the Code's mandatory standards, not its aspirational standards.) This should be a summary of the most important facts which the Complainant believes support the issuance of a formal ethics complaint. Each fact should be numbered or otherwise identified.

Essential Facts Of Complaint
 

Similar Proceedings

To the best of your knowledge, are there any other ethics complaints, regulatory complaints, or court actions that have been filed by you or anyone else that relate to the same or similar allegations contained in this Complaint form? If so, identify such complaints or other actions below. If any such actions have concluded, please describe specifically the results and attach relevant documentation. Note: The Complainant should list any actions taken or contemplated that are directed at the same or related complaints. For example, the Complainant should identify any matters filed with state licensure or regulatory boards, courts or other judicial forums, professional organizations, and employers that relate to the issues raised in this Complaint. Note that the HR Ethics Case Procedures state that the HR Department shall not consider a Complaint when civil, criminal, or regulatory proceedings are ongoing.

Similar Proceedings
  List all persons you believe have knowledge of the matters you have asserted in this Complaint and a brief description of what each person's knowledge is regarding the alleged violation. Note: Please provide each individual's full name, address, telephone number, and other contact information (e.g., e-mail address, to the extent known). Note that the HR Department is permitted to contact any individual listed here or other individuals as part of its review of any Complaint.
List Everyone Involved
  Indicate how many documents you plan to provide and then list all of the documents attached to this Complaint form. If there are numerous attachments, please utilize an indexing format, such as by numbering documents as Attachment 1, Attachment 2, Attachment 3, etc. Note: All documents must be listed by type (e.g., letter, e-mail, memo, certificate, etc.), date, and the name of the individual or organization that prepared it. All documents listed in this section must be submitted along with this Complaint at the same time that this Complaint is submitted.
How Many Documents 
List Document Names
  List all steps you have attempted to resolve the issue with the Respondent prior to the submission of this Complaint form. Be as detailed as possible.
List Attempts To Resolve
 

Statement and Certification. 

By entering my name and date below, and submitting this Ethics Complaint, I charge the Respondent identified herein with a violation(s) of the Company Code of Ethics and Professional Conduct. I agree to abide by the conditions and terms of these rules. I understand that I am required to and HR shall make reasonable efforts to keep the information that has been and will be submitted concerning this ethics proceeding confidential, as set forth in the Ethics Case Procedures and subject to all applicable exceptions. I also understand that the Respondent may receive a complete, non-redacted copy of this document, as well as other information that is submitted with regard to the ethics proceeding. I acknowledge and agree that HR may contact individuals who may be witnesses. I allow the HR to provide a copy of this Ethics Complaint to headquarters staff in the event that it alleges a false or improper use of Company property (including but not limited to an allegedly false or improper use of a company certification designation). Further, I understand that some or all of the information submitted with regard to the ethics proceeding may be disclosed (in either redacted or nonredacted form) to company members and others following a final determination by the HR Department and/ or the Ethics Appeals Panel.or the Ethics Appeals Panel.  

Confirm This Complaint
Digital Signature Name    Date of Complaint

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  Copyright    Lietz Development, Inc. 1996. All Rights Reserved.
www.datatechitp.com