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REVENUE
INTEGRITY
PROTECTION SERVICE |
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REPORT
CORRUPTION FORM
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| Title | |
| First Name | |
| Last Name | |
| Address 1 | |
| Address 2 | |
| City | |
| Phone | |
| Cellphone | |
| My position | |
| My Employer/Organization | |
| Consent for the RIPS to disclose your identity to another agency | |
| Disclosure of identity is not necessary in investigating your report. However,the Office of the Ombudsman may need to contact you for the case to progress. | Consent: Yes No |
| What
are the names and positions of the public authorities or public officials
you believe performed, are performing, or will perform a corrupt act? |
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| Are
any private citizens or companies involved? If so, what are their
names and addresses? Include any other details that may be relevant.
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| Provide a summary of the matter you are reporting. (Who, What, When, Where, and How) | |
| How
did you become aware of this matter? |
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| Are
there other people who know about this matter who could assist the
RIPS? If so, please provide their names and contact details, and indicate whether they are aware you have provided their details to the RIPS . |
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| Have
you reported this matter to another agency or public official that
may be able to assist? What, if any, has been their response to date? |
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| Do
you have, or know of, any documents related to this matter? Please describe the nature of these documents. The RIPS will request these documents if necessary. |
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| Department of Finance Revenue Integrity Protection Service 6th Floor, DOF Bldg., BSP Complex Manila Phone: 404-1775 E-mail: rips@dof.gov.ph |
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Copyright
2004 RIPS. All rights reserved
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