SHe-Box | MINISTRY OF WOMEN & CHILD DEVELOPMENT

Step 1/4 - Complainant Details

* Complainant Behalf ?

* Complainant Work Status

* Name of the Complainant

* Mobile Number

* Email ID

Step 2/4 -Details of workplace where the incident of sexual harassment occured

* Select Ministry/Department

Select Attached Office

*Pincode

*Complete Address of workplace where incident of sexual harassment occured

* Select State

* Select District

Step 3/4 - Details of the Respondent

* Name of Respondent

* Designation

Email ID

Mobile No.

*Working relationship of Respondent with complainant

* Please specify

* Are the details of workplace of the respondent same as that of the workplace where the incident of sexual harassment occured?

*Select Ministry/Department

Select Field Office

Select Attached Office

Select State

Select District

* Are there more than one Respondents ?

* Are they from same organization?

Name(s) & contact details of other person(s) Respondent :

Name	Designation	Email	Mobile	Action

Name(s) & contact details of other person(s) Respondent :

Name	Designation	Ministry/Department	Email	Mobile	Action

Step 4/4 - Complaint Details

* Have you already registered complaint with IC ?

Reference No. (If any)

* Date of lodging a complaint with .

* Reason for delay

* Type of Harassment

* Brief description of the incident with relevant facts (Max 500 words )

Please Upload Supporting Document (PDF,JPEG,PNG Only) if any

Max file size is 2 MB

* Enter Captcha here

Complaint Form