Harassment Complaint – An Aelieve Website

Employee Information

Complete This Section With The Employee's Information Who Is Filing A Complaint

First Name

Last Name

Department

Supervisor First Name

Supervisor Last Name

Incident Information

Complete This Section With The Incident Information & Employee's Name Who Complaint Is Against

First Name (Who Complaint Is Against)

Last Name (Who Complaint Is Against)

The Above Individual (Who Complaint Is Against) Is Your:

Supervisor

Subordinate

Co-worker

Other

Please Explain:

Please Provide Any Supporting Documents (photos/screenshots, files, etc.):

Choose File

Have You Ever Previously Filed A Complaint Or Provided Information To Management Verbally and/or In Writing Regarding This Incident?

Yes

Who? When? (provide any additional details as needed)

Are There Any Involved Parties and/or Witnesses? (please provide names and any additional details)

Is There Anything Else You Would Like To Share In Relation To The Incident?

I (the employee), by submitting this form, agree to cooperate in an investigation of the alleged discrimination or harassment stated herein. I understand that complaints of discrimination or harassment in violation of Aelieve One, LLC's Harassment & Sexual Harassment Policy will be promptly and thoroughly investigated and will be treated with the utmost confidence consistent with the resolution of the matter; I have truthfully and accurately submitted the above information, and understand the disciplinary measures that will be taken if my accusations are false; And understand that if the allegations are substantiated, the alleged harasser will be disciplined; I understand that any reprisal or retaliation against any person who reports or threatens to report discrimination or harassment (in good faith) is prohibited, and in addition, individuals who participate in this complaint process as potential witnesses are assured of non-retaliation.