Please enable JavaScript in your browser to complete this form.Name of Whistle Blower *FirstLastSexMaleFemaleEmail *Phone NumberYour LocationWhich MDA Are You Reporting ?Do You Have Any Relationship With This MDA?:YesNoWhat Type of Relationship Do You Have With The MDA ?What Fiscal Year Specifically In Reference Is Your Report Related To ?Was It A Single Line-Cost of Lumped With Other ELIs?YesNoWas This Projects/Items A Rolled Over Under MTEF Or Fresh Expenditure-Line For The Fiscal Year In Reference?YesNoIs Your Report Based From Questionable Variation, Inflated Cost, Questionable Bid Process, Doubled Award, Expenditure Padding, Contracts Splitting, Outright Embezzlement Without Award, Underhand Deals Or Suspicious Fiscal Mixed Up You Felt Were Questionable?Provide The Chat Of Account For The Project/Contract You Are ReportingAny Sub-head Identification?Who Is The Desk Officer For The Sector ?Who Is The Accounting Officer Responsible For This?Do You Have Any Concrete Evidence To Back Up This?YesNoCan You Testify In Court, If A Government Anti-corruption Agency Request You Do So ?YesNoHow Much Is Involved In Actual And As At When ?Have You Reported This To Any Government (Anti-corruption) Agency, Line-Ministry Or Other Public Interest Organizations ?YesNoIf Yes, To The Question Above, Provide Contact Of The Organization You Reported To EarlierHave You, Your Relations, Agents, Associates Or Interest, Executed Contracts, Supplies, Services Or Consultancy For This Agency/Sister Agencies Within The Past 5 Years?YesNoWere You Paid For All Your Services Or Jobs?YesNoBeside Public Interest, You Are Sure No Conflict Of Interest Exist Between You And The Contract You Are Reporting In Question ?YesNoAre You Aware, There Is Criminal Liability Against False Alarm, Wrongful Accusation Or Intentional Peddling Of Misleading Information, Which Is Far Different From The Freedom Of Speech Envisaged And Guaranteed in the Constitution Of The Federal Republic Of Nigeria ?YesNoSubmit
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