Serious wrongdoing reporting form

Before completing this form 

Please ensure you have read and comply with the guidance provided on the Public Interest Disclosures policy before completing this form.

Note that questions marked with an asterisk (*) are mandatory. 

Section 1: Personal information

Note that you are not required to provide us with your personal details and may remain anonymous. However, doing so may reduce our ability to progress the report as we will not be able to contact you to verify or obtain further information. We will also not be able to advise you of the outcome of our assessment. 

Any personal information you do provide will not be disclosed without your consent to anyone not involved in the assessment process or as otherwise required of NSW Treasury under law. 

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Personal Details

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Please note your report may not be accepted as a public interest disclosure as only a NSW Government employee, contractor and/or volunteer can make a report.

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Section 2: Summary of wrongdoing

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(be as specific as possible, listing multiple dates for multiple incidents)

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Select the button below to add persons. Enter as much information as possible or write 'unknown'. If needed, others may be added in 'Any other relevant details' below.

Person 1

Person 2

Person 3

Section 3: Information supporting the report

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If you wish to advise the details of other persons, select the button below to add.

Witness 1

Witness 2

Witness 3

Section 4: Additional information

Maximum 10 files.
20 MB limit.
Allowed types: gif, jpg, jpeg, png, txt, pdf, doc, docx, ppt, pptx, xls, xlsx, zip.

Note: 
If you wish to provide further documents, either now or at a later date, please email them to [email protected] noting the date and reference ID of your report.

You may also send further documents by post (though this is not preferred) to: GPO Box 5469 (Attention Governance, Ethics & Integrity Branch, Office of the General Counsel).  Please include the date and reference ID of your report.

Section 5: Preview and submit

Please review the information that you have provided and then complete the following statements. 

I declare that I have understood the questions and the information I have provided is true and complete to the best of my knowledge.
I understand that under s84 of the Public Interest Disclosures Act 2022 a person must not, in making or purporting to make a public interest disclosure or in providing information relating to a public interest disclosure, wilfully make a false statement to, or mislead or attempt to mislead, the agency or person to whom the disclosure or purported disclosure is made or the information is provided. Maximum penalty—100 penalty units or imprisonment for 2 years, or both.

 

Note: If you have chosen to remain anonymous you should record your report ID (this will display on your screen following submission), just in case you wish to contact us about it in the future. 

If you provided an email address in the form, a copy of your finalised report (including the ID report number) will be emailed to you following submission.