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BORANG PENGADUAN SALAHLAKU KAKITANGAN COMPLAINT FORM ON PERSON

A. BORANG PENGADUAN SALAHLAKU KAKITANGAN COMPLAINT FORM ON PERSON. 1.0 Butir-butir pegawai yang diadu / Details of officer to be reported 1.1 Nama / Name : ______________________________________________________ 1.2 Jawatan / Designation : _______________________________________________

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BORANG PENGADUAN SALAHLAKU KAKITANGAN COMPLAINT FORM ON PERSON

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  1. A BORANG PENGADUAN SALAHLAKU KAKITANGAN COMPLAINT FORM ON PERSON • 1.0 Butir-butir pegawai yang diadu / Details of officer to be reported • 1.1 Nama / Name : ______________________________________________________ • 1.2 Jawatan / Designation : _______________________________________________ • 1.3 No kakitangan / Staff no : _____________________________________________ • 1.4 Tempat bertugas / Place of duty : _______________________________________ • 2.0 Butir-butir kesalahan / Details of misconduct • 2.1 Tarikh / Date : ____________________ • 2.2 Waktu / Time : ____________________ • 2.3 Tempat kejadian / Location of misconduct : ________________________________ • 2.4 Keterangan salahlaku / Explanation of misconduct : • _____________________________________________________________________ • _____________________________________________________________________ • __________________________________________________________________________________________________________________________________________ • ____________________________________________________________________ • 3.0 Dokumen & maklumat sokongan / Supporting document & evidence • 3.1 Dokumen sokongan yang disertakan (sekiranya ada) / • Supporting documents attached (if any) • i. _______________________________________________________________ • ii. _______________________________________________________________ • iii. _______________________________________________________________ • iv. _______________________________________________________________ • ( Sila sertakan lampiran keterangan jika ruang tidak mencukupi / Please use additional paper should the space provided is insufficient )

  2. 3.2 Nama saksi yang melihat kejadian (sekiranya ada) / Name of witness (if any) • i. _______________________________________________________________ • ii. _______________________________________________________________ • 4.0 Butir-butir pelapur / Details of complainant • 4.1 Name / Name : ______________________________________________ • 4.2 NRIC No. / Passport No. : ______________________________________________ • 4.3 Jawatan/Designation : ______________________________________________ • 4.4 Alamat/Address : ______________________________________________ • ___________________________________________________________________ • ___________________________________________________________________ • 4.5 Tel : ________________________ • Saya mengaku bahawa segala keterangan di atas adalah benar./ I certify that all details given above are true. • Tandatangan / Signature : ____________________ • Tarikh / Date : • ___________________________________________________________________________ • Hantarkan aduan anda kepada/ Address your complaint to: • The Chairman • Remedial Grievance System • c/o Deputy Rector (Student and Alumni Affairs) • Level 4, Administration Block • International Islamic University Malaysia • Jalan Gombak, 53100 Kuala Lumpur UNTUK KEGUNAAN PEJABAT / FOR OFFICE USE No rujukan kes / Case reference No : Tarikh terima / Date received :

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