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    Borang Aduan Salah Laku: Misconduct Complaint Form

    Uploaded by

    NANTHA KUMARAN
    1) This document is a complaint form from the Enforcement Agency Integrity Commission (EAIC) for reporting misconduct by enforcement officers. 2) The form collects information about the complainant and the enforcement agency and officers being complained about. 3) It requests details of the complaint including date, location, and description of the incident along with any witnesses or supporting documentation. 4) By signing the form, the complainant acknowledges that the information provided is true to the best of their knowledge. The form will be used by EAIC to investigate allegations of misconduct against enforcement officers.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    Borang Aduan Salah Laku: Misconduct Complaint Form

    Uploaded by

    NANTHA KUMARAN
    271 views6 pages
    1) This document is a complaint form from the Enforcement Agency Integrity Commission (EAIC) for reporting misconduct by enforcement officers. 2) The form collects information about the complainant and the enforcement agency and officers being complained about. 3) It requests details of the complaint including date, location, and description of the incident along with any witnesses or supporting documentation. 4) By signing the form, the complainant acknowledges that the information provided is true to the best of their knowledge. The form will be used by EAIC to investigate allegations of misconduct against enforcement officers.

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    borang_aduan_basl01

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    borang_aduan_basl01

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    1) This document is a complaint form from the Enforcement Agency Integrity Commission (EAIC) for reporting misconduct by enforcement officers. 2) The form collects information about the complainant and the enforcement agency and officers being complained about. 3) It requests details of the complaint including date, location, and description of the incident along with any witnesses or supporting documentation. 4) By signing the form, the complainant acknowledges that the information provided is true to the best of their knowledge. The form will be used by EAIC to investigate allegations of misconduct against enforcement officers.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    271 views6 pages

    Borang Aduan Salah Laku: Misconduct Complaint Form

    Uploaded by

    NANTHA KUMARAN
    1) This document is a complaint form from the Enforcement Agency Integrity Commission (EAIC) for reporting misconduct by enforcement officers. 2) The form collects information about the complainant and the enforcement agency and officers being complained about. 3) It requests details of the complaint including date, location, and description of the incident along with any witnesses or supporting documentation. 4) By signing the form, the complainant acknowledges that the information provided is true to the best of their knowledge. The form will be used by EAIC to investigate allegations of misconduct against enforcement officers.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 6

    EAIC.

    BASL01

    SURUHANJAYA INTEGRITI AGENSI PENGUATKUASAAN


    ARAS 5, BLOK MENARA, BANGUNAN MENARA USAHAWAN,
    NO 18 PERSIARAN PERDANA, PRESINT 2
    62652 PUTRAJAYA
    TEL : 03-8880 5625 / 5626 / 5627 / FAKS : 03-8880 5646 / 5647
    www.eaic.gov.my

    eaicofficial

    BORANG ADUAN SALAH LAKU


    MISCONDUCT COMPLAINT FORM
    Akta Suruhanjaya Integriti Agensi Penguatkuasaan 2009 [Subseksyen 23(1) & (2)]
    Enforcement Agency Integrity Commission Act 2009 [subsection 23(1) & (2)]

    BAHAGIAN A/PART A
    UNTUK TINDAKAN PEJABAT (ruang ini akan diisikan oleh Suruhanjaya)
    FOR OFFICIAL USE (these spaces to be filled by the Commission)
    NO. ADUAN
    COMPLAINT NO.
    TARIKH / MASA ADUAN
    DATE / TIME OF COMPLAINT
    NAMA PEGAWAI
    MENERIMA
    NAME OF RECEIVING
    OFFICER
    (ruangan di bawah ini perlu diisikan oleh pengadu)
    (the below spaces to be filled by the complainant)

    BAHAGIAN B/PART B
    BUTIRAN PENGADU
    PARTICULARS OF THE COMPLAINANT
    Pengadu boleh memilih untuk tidak mengisi Bahagian ini/ Complainant may choose not to fill this Part
    Nama Pengadu :
    Name of Complainant:

    No. Kad Pengenalan : Umur :


    I.C. Number Age
    No. Pasport : Jantina :
    Passport No:
    Bangsa : Warganegara :
    Race : Citizenship :
    Alamat surat menyurat :
    Mailing Address :

    1
    EAIC.BASL01

    Pekerjaan :
    Occupation :
    No.Tel (h/p) : No. Tel (R) : No. Faks (jika ada):
    Mobile Number : Phone Number (H) : Fax Number (if any):

    Alamat E-Mel (jika ada) :


    E-mail Address (if any) :

    BAHAGIAN C/PART C

    BUTIRAN AGENSI PENGUATKUASAAN / PEGAWAI PENGUAT KUASA


    YANG DIADUKAN

    PARTICULARS OF THE COMPLAINED ENFORCEMENT AGENCIES


    Nama Agensi (tandakan / dalam kotak berkenaan) :
    Agency Name (tick / in the box provided):

    Polis Diraja Malaysia (PDRM)


    Royal Malaysia Police

    Jabatan Imigresen Malaysia (JIM)


    Immigration Department of Malaysia

    Ikatan Relawan Rakyat Malaysia (RELA)


    Malaysia Volunteers Corps

    Jabatan Pengangkutan Jalan (JPJ)


    Road Transport Department

    Jabatan Kastam Diraja Malaysia (JKDM)


    Royal Customs Department of Malaysia

    Agensi Antidadah Kebangsaan (AADK)


    National Anti-Drugs Agency

    Jabatan Alam Sekitar (JAS)


    Department of Environment

    Agensi Penguatkuasaan Maritim Malaysia (APMM)


    Malaysian Maritime Enforcement Agency

    Jabatan Keselamatan dan Kesihatan Pekerjaan (JKKP)


    Department of Occupational Safety and Health

    Jabatan Pendaftaran Negara (JPN)


    2
    EAIC.BASL01

    National Registration Department

    Jabatan Perhubungan Perusahaan Malaysia (JPPM)


    Industrial Relations Department

    Jabatan Perikanan Malaysia


    Fisheries Department

    Jabatan Perlindungan Hidupan Liar dan Taman Negara (PERHILITAN)


    Department of Wildlife and National Parks

    Jabatan Tenaga Kerja


    Labour Department

    Kementerian Kesihatan (Bahagian Penguatkuasaan)


    Ministry of Health (Enforcement Division)

    Kementerian Pelancongan (Unit Penguatkuasaan Bahagian Pelesenan)


    Ministry of Tourism Malaysia

    Kementerian Perdagangan Dalam Negeri, Koperasi dan Kepenggunaan


    (Bahagian Penguatkuasaan)
    Ministry of Domestic Trade, Co-operative and Consumerism

    Kementerian Perumahan dan Kerajaan Tempatan (Bahagian


    Penguatkuasaan)
    Ministry of Housing and Local Goverment (Enforcement Division)

    Jabatan Penerbangan Awam Malaysia


    Civil Aviation Department

    Lembaga Pelesenan Kenderaan Perdagangan


    Commercial Vehicle Licensing Board

    Pendaftar Perniagaan
    Registrar of Business

    BAHAGIAN D/PART D

    BUTIRAN PEGAWAI PENGUAT KUASA YANG HENDAK DIADUKAN


    3
    EAIC.BASL01

    PARTICULARS OF ENFORCEMENT OFFICERS


    Nama pegawai :
    Name of Officer:
    Jawatan pegawai :
    Position:
    No. ID pegawai (jika ada) :
    ID Number (if any):
    Nama pegawai (jika ada pegawai lain) :
    Name of Officer (if any):
    Jawatan pegawai :
    Position:
    No. ID pegawai (jika ada) :
    ID Number (if any):
    Negeri :
    State:
    Daerah :
    District:
    Cawangan / Bahagian :
    Branch / Department:
    Butiran tambahan lain (jika ada) :
    Other additional details (if any):

    BAHAGIAN E/PART E
    WAJID/MANDATORY

    BUTIRAN ADUAN: (sila berikan butiran lengkap aduan termasuk tarikh,


    tempat dan masa kejadian):
    DETAILS OF COMPLAINT: (Please give full details of the complaint including
    the date, place and time of the incident):

    4
    EAIC.BASL01

    *(gunakan lampiran tambahan jika ruang ini tidak mencukupi)


    *(please use additional sheets if this space is insufficient)

    Nama saksi kejadian (jika ada):


    Adakah terdapat gambar atau dokumen atau video tentang kejadian: Ada/Tidak
    (gambar/dokumen/video boleh dikemukakan bersama atau kemudian)

    Name of witnesses (if any):


    5
    EAIC.BASL01

    Are there any photographs or documents or video of the event: Yes / No


    (photo / document / video may be submitted together or later)

    Saya mengakui aduan dan butiran yang diberikan di atas


    adalah benar mengikut pengetahuan dan kepercayaan saya.

    I acknowledge the complaint and the details given above are


    correct according to my knowledge and belief.

    Tandatangan pengadu / Tarikh /


    Complainant signature :……………………… Date : …………………

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