A harassment report form is generally filled by a person to record a complaint against any person or group to the concerned authorities. The form is filled in detail to report the problem. A usual format of the form may contain to have information related to both: The person who is complaining and details of the incident. Details related to the applicant are general information and the other one as detailed report information. General information requires filing person’s name, complete address, contact number, occupation, designation, age, gender, company name in which he/she is working etc.
On the other part the detail report form information may require writing date and day of harassment, place of incident, causes and a brief description of the incident, type of harassment: was it physical, mental or any other type? It is suggested to include if there is any witness of the incident. In case the witness is found his/her details will also be mentioned in the form. Most probably required information would be his/her complete name, address, contact number and I.D card number etc.
It is better to explain about details of incident occurred. What was the intensity of the incident and how does it affect victim’s mental and physical condition. Is there any permanent damage has been made or does it put long-lasting effects on victim’s health? It must also be included if any authorities have been informed already about the incident. In case the information related to that authority should be mentioned.
Finally, the declaration has to be made by the applicant that all the information that is written in the form is correct and genuine. Nothing wrong or false has been written. Applicant should sign the report with date mentioned. The free printable harassment report form attached with this contains all above-mentioned information. One can download this form and can use it directly. However, one can edit and print as per one’s requirement. A preview is also added to have quick look at its appearance.
Harassment Report Form Template
Microsoft Word document file | File size 37 KB | Download
The file can be download in OpenOffice format (.odt)
File size 21 Kb | Download