​​Complaint Form

NOTE: Complaints shall be registered if the cases are found in / belong to Karnataka State. We regret to inform that complaints of other region will not come to our jurisdiction.

 

 

 

Complaint date

:

 

Complainant name*

:

 

Contact number(optional)

:

e-mail id(optional)

:

 

Address *

:

 

District*

:

 

Taluk*

:

  

Area/Village*

:

 

Road/Cross*

:

 

Name of the Organization/House No *

:

 

Do you wish to hide your identity

:

Yes

No

Please register your complaint

No.of Child Labour/ers observed (Sholud be below 14 years)

:

                      

 

Child name(s)

Age

Gender

1

 

  

       

 

Name of the Employer/Organization *

:

 

Type of work *

:

 

State *

:

  

 

       

 (other) 

District *

:

 

Address of Employer/Organization

City/Town/Village *

:

 

District *

:

  

Taluk *

:

  

Area *

:

 

Cross/Main road *

:

 

Number *

:

 

Contact number(optional)

:

 

 

 

 

All the fields marked with * are mandatory​