Step 1: Incident Info
Step 2: Reporter Info (optional)
Step 3: Confirmation
View/Edit an Existing Report

Incident Report

Instructions for completing the incident report:

When providing information or answers to questions, please be as specific as possible, as this will assist in an appropriate response.
If you don't know the answer to a question or the information requested, please simply indicate that.
After completing the report you will have the option to identify yourself.
Once you complete the report and submit it, you will receive a unique "Report ID#" which will serve to confirm that your report has been submitted and will allow you to report additional information in the future.

Please indicate if you are seeking guidance on an issue or reporting a suspected or known problem or violation.

Please describe in detail what is occurring or the specific issue or concern:

Please identify the dates and times this has either occurred in the past or when you believe it will occur in the future.

Where is the activity taking place (address, building, floor, office, etc., if known)?

Please identify in detail any and all evidence that you believe exists, including the type of evidence, (e.g., documents, email, voice mail recording, etc.), where it is located, who has control over it, etc.

Does the activity you are reporting involve any equipment, vehicles or other property of the organization? If so, please describe in detail what is involved, its original location, how to identify it, its current location, etc.

Please indicate if you believe any company records were falsified and, if so, identify what was falsified, if known.

Please identify all individuals you believe are involved in, know about, have evidence of or would be able to get evidence of the activity you described above. Include as much detail as possible including names, titles, departments, how they were involved, physical descriptions, times and dates of his/her involvement, etc., and whether they know you are aware of or suspect their involvement.

Please indicate if you have reported this to anyone else and if you have, who you reported it to, when and what if any action was taken as a result?

Please describe your relationship with the organization. For example: current employee, former employee, owner, customer, client, officer, supplier, director, other (please specify).

Please provide any other information or comments you'd like us to know in connection with the activities or incidents identified in this report.

Reporter Info

If you wish to remain anonymous skip these questions. If you do not wish to remain anonymous or you would like to speak with a representative of the company please indicate that and provide us with your name, address, phone number, e-mail address or the preferred or other contact method.

Your name:

Your Address:

Your Phone number:

Your E-mail address:

Preferred or Other Contact Method:

Confirmation

Thank you for submitting your report to the WipfliWatch Line anonymous ethics and fraud reporting website. Your identity will be confidential and Wipfli will not divulge any information about you to the Client Organization unless you identified yourself in the report. All information you provide will be passed on to the appropriate personnel. Use the [Back] button if you want to review or edit your report before submitting it.

Your report ID# is:

Please record your report ID# displayed above and create a password below for later access to your incident report.

Password:
Confirm Password:

By checking this box, I acknowledge that if I lose the report ID number or password, I will have no way of reviewing this information due to confidentiality rules. I authorize Wipfli LLP to provide the information contained in the report to the Organization identified above.

View/Edit an Existing Report

Welcome back to the WipfliWatch Line anonymous ethics and fraud reporting web site. Your identity will be confidential and Wipfli can not divulge any information about you to the Client Organization unless you identify yourself in the information you supply. All information you provide will be passed on to the appropriate personnel.

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Report ID#