Whistleblower Reporting Form

Appendix WB1: Download Whistleblowing Form (PDF)

Choose either submission method:

Download Appendix WB1, print and complete it, then scan and attach the completed copy under Completed Appendix WB1 / Supporting Evidence below.
Complete the online form below, beginning with A. Disclosure Details. A scanned Appendix WB1 is not required when the online form is completed.

Submission Title / Subject

Disclosure Details

1. Party involved in concern raised

Name of Alleged Wrongdoer

Designation

Division / Company

How do you know this person?

2. Details of concern

Date / Time / Location

Description of Concern

3. Supporting information to assist investigations

Provide any witness or evidence details that may substantiate the disclosure and assist the investigation.

Witness Name

Witness Department

Completed Appendix WB1 / Supporting Evidence

Optional when completing the online form. If using the printed Appendix WB1, attach the completed scanned copy here. You may include up to 3 PDF, JPG or PNG files in total, maximum 3 MB each and 6 MB combined. Files are sent with the report and are not retained by this form.

Reporting to Other Parties

Have you raised this concern with another person, department or authority?

Yes No

If yes, state the person, department or authority and the date reported

Particulars of Whistleblower

You are encouraged to provide your contact details so TradeVSA can contact you for further clarification if required. An accessible email address is required for the acknowledgement.

Name

Designation / Occupation

Contact Number

Email Address

Relationship with TradeVSA (if not an employee)

Please provide an email address that you can access. An acknowledgement will be sent to this address after your submission.

Required fields

Whistleblowing matters:

Email: whistleblower@tradevsa.com

Mail:

The Independent Director/The Chairman
TradeVSA System Sdn Bhd
A-16-13, Block A, Level 16
Tropicana Avenue, Persiaran Tropicana
47410 Petaling Jaya, Selangor