Code: KM-E-1 WITNESS DISCLOSURE FORM Name of witness:_________________________________________________ Position/Grade of witness:_______________________________________ Date of testimony, Interview:____________________________________ Description of Incident witnessed:_______________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ Any other information:___________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ I agree that all of the information on this form is accurate and true to the best of my knowledge. Signature:_____________________________________ Date:________________________________ Code KM-E-2 SEXUAL HARASSMENT COMPLAINT FORM Name of complainant:_____________________________________________ Date of complaint:_______________________________________________ Name of alleged harasser:________________________________________ Date and place of incident or incidents:________________________________________________ ________________________________________________________________________________ Description of misconduct:___________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Name of witnesses (if any):___________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Evidence of harassment, i.e., letters, photos, etc. (attach evidence if possible): ________________________________________________________________________________ ________________________________________________________________________________ Any other information:_____________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ I agree that all of the information on this form is accurate and true to the best of my knowledge. Signature:____________________________________ Date:________________________ |
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