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KM E-1 -E-2 Policy - Witness Disclosure Form



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:________________________
Ċ
ptefertiller@sublette9.org,
Mar 22, 2013, 10:54 AM
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