Case referral form – Suspected labour trafficking

1 Enter details of the case:

Edit

Name of suspected culprit

Contact number of suspected culprit

Address where suspected trafficking occurred

Time / Period when victim(s) is/are seen at the address

Suspected number and gender of victims

Brief information on the case

Were any of these signs present?

Has the victim(s) approached any government agency or NGO for assistance?

How did you come to know about the case?

Any other information or details

In order for us to make a quick and complete assessment on the case, we seek your cooperation to ensure that all the questions in this form have been completed. Your information will be kept strictly confidential.

Name of suspected culprit

Contact number of suspected culprit

Address where suspected trafficking occurred* (e.g. Where to find the victims)

Time / Period when victim(s) is/are seen at the address*

Suspected number and gender of victims (e.g. Number of females and males)

Brief information on the case* (e.g. Describe what happened and provide the name of victim(s), gender, nationality and contact number if available)

Were any of these signs present? Threat Physical abuse Restriction of movement Restriction of means of communication Coercion

Has the victim(s) approached any government agency or NGO for assistance? No Yes

How did you come to know about the case?

Any other information or details

1 of 2