STEP 1: Complaint Details
STEP 2: Offender Details
STEP 3: Victim Details
STEP 4: Complaint Summary

Web Site

I'm filing a complaint *

I want to report a complaint: *

Anonymous Confidential

Reported Date Auto

Describe the Adversity

How severe is the complaint? *

Low Medium High Urgent - Life Threatening

What is the purpose of the complaint? (Check all that apply) *

Prevent of harming oneself and others

Protect the safety of the victim

Protect the safety of the offender

Stop the offenders abusive behavior

Seek advice, support, and/or guidance

Report to an appropriate authority

Informal and internal investigation

Resolve the situation

Monetary compensation

Other

Where did the situation occur? *

Physical Digital/Online/Phone Both

If you would like to upload documents, images, videos, emails and/or other files, click on the button below

Upload images, links, documents, screenshots, videos, etc.

Select the type of offense. Check all that apply:

Verbal and/or Written

Discrimination: Religion, color, age, gender, ethnicity, and/or race

Discrimination: Disability and/or physical attributes

Shaming, humiliating, demeaning, teasing

Spreading rumors, disparaging, defaming

Taunting, intimidating, retaliating, threatening

Cussing, Swearing, Using of Profanities

Digital: Social Media, Phone, Internet, Computer

Discriminatory slurs: Religion, race, ethnicity, color, gender, physical appearance

Discrimination: Disability or/and special needs

Identity theft with harmful outcomes

Disseminating child pornography pictures, videos

Deceptive or misleading website/domains

Unsolicited obscene materials sent to minors

Hacking into someone s computer

Publishing harmful and defamatory information

Sharing inappropriate pictures /videos without permission in a private place

Threats to harm, kill, or shoot someone or public locations

Cussing, taunting, intimidating, and bullying

Personal Property and Physical Space

Violation of personal space, Hovering

Damaging and destroying stuff

Theft

Locking in a closed space against one s will

Stalking, following someone to induce fear

Threatening with knife or sharp tools

Mobbing and/or ganging up on someone

Showing or/and displaying private parts

Abuse of Power and Authority

Discrimination

Retaliation and intimidation

Verbally abusive and shaming

Coercing physically

Sexual predator

Cover Ups

Physical Injury and Sexual Misconduct

Inappropriate touching, massaging, or robbing body parts

Groping private parts or touching private parts inappropriately

Grooming, Molestation

Tying or coercing one against their will

Urinating or pouring materials harming one

Sex trafficking minors

Rape

Hazing

Physical injury level 1

Physical injury level 2

Harassment

Verbal intimidation

Personal space violation

Stalking, threatening, and following

Inducing fear and threatening

Locking someone in a closed space

Describe the impact of this behavior(s)

Emotional distress

Safety and distrust

Damage to property and personal belonging

Physical Injury

Describe Incident/Situation

How often does the offensive behavior occur*? *

It occurred only once

It occurred once a month

It occurred once a week

More than 3 times a week

Other

Offender Details

Offender Details

Is the offender aware of the situation? *

Yes

I don't know

What was the intent of the offender?

Innocent or just an accident

Consensual

Not sure

Deliberate with the intent to harm (targeted)

Do you have evidence that could be uploaded?

No Yes

If you would like to upload documents, images, videos, emails and/or other files, click on the button below

Click here to upload evidences

Do you have witnesses?

Yes No

Victim Details

victim initial
Initial

victim first name

victim last name

victim gender

victim email

Phone

Victim Race

victim age

Victim Address

Victim zip code

Victim State

Victim City

more victim 1

Are you aware of others in similar situations?

Was the victim intoxicated?
Yes No I don't know

Did the victim have a weapon?
Yes No I don't know

Is the Victim impaired/disabled/handicapped?
Yes No I don't know

What is your desired outcome

Do you or the victim need additional help?
Yes No

Reporter Information

Offender Details

Offender Description

Offender Intoxicated:
Offender Carrying weapon:
Offender Disability: :
Offender was informed:
Shall We Inform Offender:

Organization Details

Complaint Details

Complaint Categories

Offended Party/Victim Details

More Details

Let's Start Resolution

I read the disclaimer and agree to its terms! Yes

I read the disclaimer and agree to its terms!

I agree to the terms and conditions

ICIARA: Independent Complaint Investigation Assessment Resolution Application

Your complaint can be reported anonymously or confidentially.

But please note in order for your complaint to be accurately assessed,

please provide as many details as possible in a truthful and verifiable manner.

Reporter Information

Offender Details

Organization Details

Complaint Details

Offended Party/Victim Details

Let's Start Resolution

ICIARA: Independent Complaint Investigation Assessment Resolution Application

Your complaint can be reported anonymously or confidentially. But please note in order for your complaint to be accurately assessed, please provide as many details as possible in a truthful and verifiable manner.

Your complaint can be reported anonymously or confidentially.

But please note in order for your complaint to be accurately assessed,

please provide as many details as possible in a truthful and verifiable manner.