File a Misconduct Report

THIS IS NOT A 911 OR EMERGENCY SERVICE. Do not use this site to report events presenting an immediate threat to life or property. Reports submitted through this service may not receive an immediate response. If you require emergency assistance, please contact your local authorities.

Do You wish to remain ANONYMOUS of this report?(Required)

Yes

If you want BSA Claims Solutions to know your identity, please complete the following:

Name

First Last

Phone

Best time to contact you:

Person Inquiries

Names

Name

Position

If more than one person involved hit the + on the right side.

Do you suspect or know that a supervisor or management is involved?

Yes

I Don't Know / Do not wish to disclose

If Yes, then who

Any persons mentioned here will be restricted by BSA from access to this reported information.

Is management aware of this problem?

Yes

I Don't Know / Do not wish to disclose

What is the general nature of this matter?

This should be a general description only,

Where did this incident/violation occur?

While we understand that this incident might not be tied to a specific location, if it has been documented or referenced in any business transactions, please specify accordingly.

Please provide the specific or approximate time this incident occurred:

Examples: Tuesday, May 3, 2002 Two weeks ago Approximately a month ago

How long do you think this problem has been going on

How did you become aware of this violation?

If other

If other, how?

Kindly identify individuals who have tried to hide this issue and outline the actions they took to do so.

Please identify by name and title.

If you have a document or file that supports your report

Max. file size: 50 MB.

Please provide all details regarding the alleged violation, including the locations of witnesses and any other information that could be valuable in the evaluation and ultimate resolution of this situation.

Please take your time and provide as much detail as possible, but exercise care not to provide details that may reveal your identity unless you wish to do so. It may be important to know if you are the only person aware of this situation.