Whistleblowing Form

I confirm that I have read the Regulatory Act and general information Whistleblowing

Form for reporting misconduct by public employee pursuant to Article 54-bis of Legislative Decree 165/20

Alternatively, you can through the following link, make a report directly to ANAC: https://servizi.anticorruzione.it/segnalazioni/#!/#%2F

Data of the reporter

(The data entered will be processed while protecting the confidentiality of the reporter's identity throughout the proceedings under the jurisdiction of the Ministry of Justice)

Name of the reporter*

Last name of the reporter*

Tax Code*

Current service qualification*

Assignment (Role) of current service*.

Current Organizational Unit and Place of Service*.

Service qualification at the time of the reported incident*

Duty assignment (Role) at the time of the reported incident*

Organizational Unit and Place of Service at the time of the fact*.

Phone

If reporting has already been done to other parties, fill in the following table:

If no, specify the reasons why the report was not addressed to other parties

Data and information Reporting Illicit Conduct:

Entity in which the event occurred*

Period in which the event occurred*

Date on which the event occurred

Physical location where the event occurred

Person who committed the act: First Name, Last Name, Qualification (multiple names may be entered)

Any private entities involved

Any enterprises involved

Ways in which he became aware of the fact

Any other individuals who can report on the fact (Name, surname, title, contact information)

Area to which the fact can be referred

- If 'Other', specify

Sector to which the fact can be referred

- If 'Other', specify

Description of the fact*

The conduct is unlawful because

- If 'Other', specify

Attach a copy of an identification document of the reporter and any accompanying documentation to this form.

The reporter is aware of the responsibilities and the civil and criminal consequences provided for in case of false statements and/or formation or use of false documents, also pursuant to and for the purposes of Article 76 of Presidential Decree 445/2000

I have read and understood theprocessing information Of my personal data.