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Application form
Signalist 2.0
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compulsory fields
1
Step 1
2
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3
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4
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Data on the applicant
Statement
*
I declare that when submitting this internal notification, I have reasonable grounds to believe that the information being the subject of the notification is true at the time of notification and that it is information about the violation of the law
Name
*
0 of 500 max characters
Last name
*
0 of 500 max characters
Place of employment
*
- choose -
Polish post office
Other
Company name
0 of 500 max characters
Official position
0 of 500 max characters
Report from PP SA
*
- choose -
employee
Employee candidate
former employee
temporary worker
a person providing work on a different basis than the employment relationship, including on the basis of a civil law contract
entrepreneur
proxy
shareholder or partner
member of the company's body
a person providing work under the supervision and management of the contractor, subcontractor or supplier, including on the basis of a civil law contract
trainee
volunteer
apprentice
E-mail address
*
Phone
Data on the persons to whom the application relates
Data on the persons to the notification (the possibility of adding several people)
Person/person reported
Name
Last name
Place of employment
Position
Role in the event
Data on the entity in the event
Name
*
Last name
*
Place of employment
Position
Role in the event
*
- choose -
perpetrator
accomplice
helper
different
Data on the entity in the event
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Infringement area
Infringement area
- choose -
corruption
public procurement
services, products and financial markets
counteracting money laundering and financing of terrorism
Product safety and their compliance with requirements
Transport safety
environmental protection
radiological protection and nuclear safety
Food and feed safety
health and well -being of animals
public health
consumer protection
Protection of privacy and personal data
security of network and ICT systems
Financial interests of the Treasury of the Republic of Poland, local government units and the European Union
European Union internal market, including public law rules and state aid and taxation of legal persons
Description of the violation
*
0 of 800 max characters
Describe the scope of violation of the law, which is the subject of your application. Give the circumstances of his incident, according to the knowledge you have:
What really happened?
Where and when did the violation occur?
How did the violation happen?
What was the development of events (in chronological terms)?
Why do you think there was a violation?
What were the motives of people associated with the case?
What effects, in your opinion, caused a violation of the application described?
Before submitting the notification, did you take action to eliminate the disclosed violation of the law or its effects (e.g. through previous reports to superiors)? If so, replace them.
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Possibility to send files:
select one or more files. The allowed file formats are :.pdf, .docx, .doc, .jpg, .png, .bmp, .txt, .xlsx, .xls, .csv, .msg, .mp4, .mp3, .jpeg, .havi, .mov. The size of a single file cannot exceed 10 MB, in total you can add files with a total size of up to 100 MB.
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Accepted File Types: PDF, DOCX, DOC, JPG, PNG, BMP, TXT, XLSX, XLS, CSV, MSG, MP4, MP3, JPEG, AVI, MOV, MOP, Max. File Size: 10 MB.
Consent verification
Do you consent to the disclosure of your personal data provided in connection with the notification other than the persons appointed by PP appointed for activities related to accepting applications and taking subsequent activities in connection with them?
*
Yes, to an unlimited circle of people
Yes, but only to the people I indicate
NO
Indicate people
*
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I got acquainted
*
I have read the
GDPR
.
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captcha
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Comments
This Field is for Validation Purposes and Should Be Left Unchanged.
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