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1.1 About which company would you like to make this report?

ǂHarugu!khaib /ons:

1.2 Where is the company located?

Department / Section:

1.3 Please indicate your relationship to the company reported.

Toxoba xoa!ga!ga:

1.4 Would you like to provide your name?

Contact information:

2.1 Please select the applicable Incident Type from the list below that best describes the issue(s) you are reporting:

Toxoba xoa!ga!ga:

3.1 Do you know the name of the person(s) or organisation(s) involved?

/Ons / /Ondi:

3.2 Do you want to add another involved party?

Hâ i nîs kara o, /ons / /nondi?

3.3 Has management been notified?

#an#an ko khoe-i di /onsa xoa!ga!ga.

First name
Last name
What date was the individual notified? YYYY-MM-DD

4.1 When did the incident occur?


4.2 Where did this incident occur?

4.3 How do you know about this incident?

4.4 Is any supporting information available?

4.5 Please provide a detailed description of the incident. Sao ra na ra sîsenūse: //aeb, //khâbtsēdi,!kaib tsî /ondi hoadi. Tare-e ge dī khoe-e? Mâpa ge nē xū-e dī khoe-e? Mâ//ae ge nē xū-e a dī khoe-e? Mati ge nē xū-e a di khoe-e? ǂAnsa ū re ne !harib / !khaib ge kai /oa disi (5000) soadi /guide !khōǂgā ha.

4.6 Do you know whether this incident will reoccur:

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