Incident Report Form: Focal Points

Relief International (RI) is committed to promoting an organizational culture that incorporates safe and ethical practices. This form is intended for RI country-level focal points. Focal points, please complete this incident report form within 24 hours of the reported incident. The report will go directly to RI's Global Incidents Management Team for further review and action. For any questions, please e-mail incidents@ri.org or consult the policy at https://relief.sharepoint.com/sites/Intranet/Risk/SitePages/Incident-Report.aspx NOTE: Security focal points - all critical security incidents must also be reported immediately to RI's Global Director of Safety and Security by e-mail, phone call, SMS or Whatsapp: raymond.bonniwell@ri.org or +1 703 338 9347 For more resources and information, please go to this folder on Box: https://ri.box.com/v/reportingandmanagingincidents

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If the incident took place in Syria, please include the country of the team managing the incident (e.g. Turkey/Syria, Jordan/Syria, etc.).

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Type of Report*

Does the report concern RI directly or is it from our Partner or a Note to File?

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Security Incident Type (if relevant)

Please select N/A, if you are not reporting on a security incident.

Security report status*

For security follow up purposes please choose whether the SIR is for records only or requires further actions to be taken (e.g investigation or mitigating actions):

A short sentence to summarize what happened (e.g. vehicle accident, procurement fraud etc...)

Please select the proposed severity grade for this incident - the grade should be chosen following conversation with the Country Director and based on this criteria: https://ri.box.com/v/severitygrade

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Examples include (but are not limited to) RI staff, beneficiaries and partners.

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If yes, please describe:

If yes, please check this box:

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Please select all the Donors funding the Country grant associated to this incident or overall Donors for the Country if not linked to a specific project

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Please list the grand numbers associated with the donors, list all if not linked to a specific grant

What happened? How and why did the incident occur? Who was involved? What has been harmed or damaged? What immediate steps have already been taken to prevent harm or further harm? Has the incident already been reported locally (authorities, police, other agencies etc)?

If there is any potential Financial Loss to RI, please state below in USD (estimate if not certain)

(beneficiaries, staff, programmes etc)

(name, title, contact information)

Please list your follow up plan for this incident.

Any initial key learning points from this incident?

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Security incidents:

Please ensure all Country and Regional Security personnel are made aware of the incident and receive a copy of this report. To send a copy of this report, tick the box below, enter your email and then forward that email report on to the relevant persons. All critical security incidents must also be reported immediately to RI's Global Director of Safety and Security by e-mail, phone call, SMS or Whatsapp: raymond.bonniwell@ri.org or +1 703 338 9347

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