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Whistleblower Program Complaint Form

AUTHORITY: San Francisco Charter, Appendix F, Section F1.107, directs the Controller, as City Services Auditor, to administer a whistleblower program and investigate reports of complaints concerning the misuse of city funds, improper activities by city officers and employees, deficiencies in the quality and delivery of government services, and wasteful and inefficient city government practices.

RETALIATION: No City officer or employee may terminate, demote, suspend or take other similar adverse employment action against any City officer or employee because the officer or employee has in good faith filed a whistleblower complaint. An act of retaliation should be reported immediately to the Ethics Commission, which will investigate any such report.

Complaint Tracking Number

K5LU6Wg3

Disclosure

Anonymous - If you elect this status, do NOT provide your name or other personal identifier

Consent to Disclosure - I consent to the disclosure of my identity to other City departments and other appropriate governmental agencies outside the Whistleblower Program in order to further investigation of this complaint.

Non-Consent to Disclosure - I do not consent to disclosure of my identity to other City departments and other appropriate governmental agencies, but I understand that non-disclosure of my identity may hinder the Whistleblower Program’s ability to investigate and appropriately address the complaint. I further understand that the Whistleblower may, in some cases, decide it appropriate to disclose my identity to another City department or appropriate governmental agency in the following situations, as permitted by City ordinance: (i) To the extent necessary to conduct a civil or criminal investigation or take enforcement action (including discipline of employees and remedial action against contractors) and (ii) to refer the matter to another City department, officer or employee to investigate and take enforcement or remedial action. (Campaign and Governmental Conduct Code Sec. 4.123(c).)

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