SHe-Box | MINISTRY OF WOMEN & CHILD DEVELOPMENT

Step 1/4 - Complainant Details (Email address is mandatory)

* Complainant Behalf ?

Self
Any Other

* 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 State

* Select District

* Select Organization

*Name of Organization

*Name of the Contact person

Mobile No. of the contact person

Email Id of the contact person

Address of the organization

Step 3/4 - Details of Respondent

* Register complaint with:

IC
LC
Note : Select LC where total no. of employees in organization is less than 10

Details of the Respondent / Accused

*Name of Respondent

* Designation

* Email ID

Mobile No.

*Working Relationship

* Please specify

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

*Select State

*Select District

*Select Office

*Select Sub Office

* IC Name

* LC Name

* Is there more than one respondent ?

* 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 .

* 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

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Complaint Form

Complaint Form (Private Sector)

Details of the Respondent / Accused