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Devonport City Council

Public Interest Disclosure v2


Your Informtion:

Full Name:  

Address:

Contact Number:   

Email:

 

Categories of Public Interest Disclosure:

 

Disclosure Details:

When did the alleged events occur? 

Summary of matters to disclosure:

 

Additional Information:

Description of any documents provided or name/s of witnesses

Have you reported this information to any other person or authority?

Please note: The above information summarises the submission. To view the entire submission, please check your email where a copy has been sent to you.

Agreement:

By signing this form you agree that the information you have been provided is true and accurate to the best of your knowledge and understand that under Section 87(1) of the Public Interest disclosures Act 2002, it is an offence for a person to knowingly provide false information under the Act to certain officers (including the Ombudsman) with the intention that it be acted on as a disclosed matter. The provision provides for a maximum penalty of 240 penalty units or two year’s imprisonment, or both.

 

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Devonport City Council https://www.devonport.tas.gov.au
Signature Certificate
Document name: Public Interest Disclosure v2
Unique Document ID: 0cadb299007a2d9218999c3ae036a9e1ef2af6dc
Timestamp Audit
March 13, 2020 4:02 pm AESTPublic Interest Disclosure v2 Uploaded by Devonport Council - council@devonport.tas.gov.au IP 1.152.104.92