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WHISTLEBLOWING (D.Lgs. 24/2023) REPORTING FORM

It is recommended to attach all the documentation that is considered useful to support the Report; if the Report is made verbally, such documentation can be delivered in analog form.
If what is reported is not properly substantiated, the Whistleblowing Committee may request any additions to the reporting.

Declaration
- I expresselly declare that I wish to benefit from the protecion of whistleblowing and, consequently, I request that this report, if received by a non competent person (i) be trasmitted, within seven days of its receipt, to the competent person, (ii) that I be given contextual trasmission news
Data of the reporting person
Name and Surname
(not mandatory data - you can submit the report anonymously)
Membership and qualification structure
(non-compulsory data)
Selected contact channels
(e.g. private email address, telephone number, etc.)
The Reporting Person has a private interest linked to the Reporting?
- Yes
- No
Specify the nature of the private interest linked to the Reporting
Is the reporting Person co-responsible for the violations he reports?
- Yes
- No
Reported unlawful act
The circumstances of the time and place of the event to which the Report relates
Business area to which the fact can be referred
Parties involved
It is sufficient to indicate the generalities or other elements that allow to identify the subject to be attributed the reported facts.
Description of the event to be reported
Other subjects that can report on the facts reported?
- Yes
- No
Specify which subjects and when
Attachments
Déposer les fichiers ici ou
Taille max. des fichiers : 20 MB, Max. des fichiers : 20.
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Comments
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Data of the reporting person

Reported unlawful act