Bear Valley Springs Association Whistleblower Reporting Form

The purpose of this form is to provide a mechanism to encourage reporting of any action or suspected action taken within Bear Valley Spring Association that is illegal, fraudulent, and unethical or in violation of any adopted policy of the Association in a safe environment. Anyone reporting a violation must act in good faith, without malice to the Association or any individual, and have reasonable grounds for believing that a violation occurred. [Any report that the complainant has made maliciously or any report that the complainant has good reason to believe is false will be viewed as a serious disciplinary offense.]

NO ONE WHO IN GOOD FAITH MAKES A REPORT OR COOPERATES IN THE INVESTIGATION OF A VIOLATION SHALL SUFFER HARASSMENT, RETALIATION, OR ADVERSE EMPLOYMENT CONSEQUENCES.

(* Indicates required fields)

Is this the first time you are filing a report for the improper conduct? *
Yes
No, please state the date(s) or approximate date(s) of your previous report(s).

Name of Person Filing Report

You are not required to provide your name and may retain anonymity. If you choose to provide your name, it will remain confidential whenever possible. Providing your name may facilitate the investigation of the misconduct. Anyone filing an anonymous report will not be updated as to the progress of the investigation, but do understand that investigations are taken seriously and will be addressed. Making a complaint does not automatically shield you from consequences of your own involvement in unlawful or improper conduct. However, full and frank admissions may be considered in deciding disciplinary actions.

Name:

Date: *

Name of Person(s) Subject to this Complaint

Name: *

Name Relation/Position: *

If this person is not an employee of the Bear Valley Springs Association, please list his or her position or relationship to the Association. (e.g. Board Member, Volunteer)

Complaint Report

Please include as much detail as possible to enable a thorough investigation of the matter. Please go beyond the question prompts and the lines provided if necessary to adequately describe the matter.

1-What act occurred and how do you believe it was fraudulent, illegal, or inappropriate?
If applicable - please describe the nature of any injury or damage sustained: *

2-When and where did the misconduct occur?
(Please indicate if the actions were committed over a period of time): *

3-Are there any witnesses that can confirm the misconduct?: *

EVIDENCE: Please attach a copy or original of any supporting documents or other evidence in your possession, if any. DO NOT ATTEMPT TO OBTAIN more evidence. You are a reporting party and not an investigator of the misconduct:

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