Online Claim Form

    Would you like to keep anonymity?

    Name (*)

    Last Name (*)

    Phone number

    E-mail (*)


    Can you identify name of persons involved in the situation?

    Can you state the date when it occurred?

    Select a month (*)

    Forgery or falsification of Documents

    Consists on the falsification, fabrication or forgery of a document, contract or registry-or any portion of it- tending to take advantage or distort a transaction or situation.

    Misuse or not authorized dissemination of confidential information

    Provide information or documents to any person, without previous and explicit authorization by the company, regarding the Organization, executive staff, workers, processes, production, customers, providers, contractors, etc., and, in general, any misuse of confidential information, including intellectual property or copyright, aiming to benefit personal interests or those of a third party.

    Misappropriation of assets

    Fraudulent appropriation, for personal use, of properties entrusted to the worker´s care. Misuse of goods or information pertaining to the company, for personal benefit. Take advantage of the position or responsibilities in the company for appropriation of goods or resources of the Organization.

    Fraud and lack of professional ethics

    Recording and systematic analysis of commercial and financial transactions, not in line with rules and procedures regularly accepted. For instance, incorrect recording of revenues, expenses or assets. Incorrect application of usually accepted accounting procedures; illegal transactions.

    Discrimination and harassment

    Physical or verbal misconduct against a counterpart, based on race, color, nationality, citizenship, belief, religion, religious affiliation, age, sex, gender, pregnancy, maternity, caring for others, civil status, sexual orientation, transgender people, genetic data, physical or mental condition, soldiers or war veterans, any person victim of domestic or sexual violence or abuse, or any other condition that is protected by law.

    Conflict of Interests

    Refers to a person with private or personal interests that might conflict with the proper performance of their duties. For instance, improper relations with vendors or customers, corruption, misuse of confidential information, participation in related companies, or participation in companies owned by providers or customers.

    Other illicits

    If you have any document or file to support your claim, please attach:
    (txt, docx, pdf, jpg, png, zip)

    Please describe the details of your claim for proper evaluation and final settlement (*)

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