Make a report – WWF Indonesia – Canary Whistleblowing System

1 What

2 When

3 Who

4 Additional Info

5 Submit

4. When and where did the case occur?
Date Time Province City District

Date format: day/month/year Time format: hour:minute
5. Since when has the case been occurring?
6. How did you know about the case?
7. Was the information obtained directly (from victims/suspect) or indirectly (from witnesses / other people)?
- Directly
- Indirectly
If the information is indirectly, please state the name of the source:
Title Name Division / Position

15. Do you have anything to add related to the case?
16. Would you like to upload some files?
Drop files here or

Accepted file types: jpg, jpeg, png, gif, pdf, docx, xlsx, mp3, mp4.

17. How would you like to be in the report?*
- I do not request Confidentiality and Anonymity.
- I wish my identity to remain Confidential.
- I wish to remain Anonymous.
I do not request Confidentiality and Anonymity.
I am able to be contacted for additional information and I do not place any restrictions on the release of my contact information.
I wish my identity to remain Confidential.
I am able to be contacted for additional information, but my name is kept confidential and is not shared.
I wish to remain Anonymous.
I choose to remain anonymous and it is not necessary for me to fill out the contact information. It is important to note that unless you provide us with another contact detail/email, we would not be able to contact you if we need additional information about your complaint.
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Do you want to create an account?
- Yes, I wish to create an account with the data below
- No, i do not wish to create an account
Creating an account allows you to track the status of all your reports as well as provide additional information and communicate with us.
Name or Alias*
Email*

If you create an account, this email will be used to login and for further communication.
Name or Alias
Email
Employee Number
Phone
Address
Street Address City State / Province / Region ZIP / Postal Code Country
ID Number
How may we contact you?
- Telephone
- Email
- Interview in person
- Other
Please specify: