Grievances

1.Contact Information
Required. ATIDI does not process anonymous complaints
Name*
Telephone
Email*
Gender
- Male
- Female
- N/A (for organizations or representatives of a community)
Are you a representative submitting this complaint on behalf of the complainant(s)?
- Yes
- No
If you selected Yes, please attach a copy of the representational authority signed by the complainant(s)/members of the community.
Max. file size: 512 MB.
Do you consent to have your personal information shared with the Borrower(s) and/or relevant third parties (e.g., insured, project implementing agency, etc.) of the project you are complaining about?
- Yes
- No
If you selected No, please elaborate
Do you fear retaliation for making this complaint?
- Yes
- No
If you selected No, please elaborate

2. Project Information
Project Name:
Country:*
Project Location*

City, etc.
3. The Complaint
Please explain the type of harm you believe ATIDI-supported project has caused or is likely to cause you or your community.
Social
- Yes
- No
Environmental
- Yes
- No
Other
- Yes
- No
Comments

Comments

4. Efforts to resolve the complaint
a. Have you raised your complaint through the project-level grievance mechanism?
- Yes
- No
b. What action was taken by the project-level grievance mechanism to resolve the complaint?
You may print the form and sign it. Alternatively, you may click in the box below and add a photo of your signature if you prefer.
Signature Upload
Max. file size: 512 MB.
Date of complaint:*
MM slash DD slash YYYY
Please attach supporting documents, if available.
Max. file size: 512 MB.
ATIDI will process your personal data submitted in this form in accordance with the ESG policy. ATIDI will not disclose any information that may reveal your identity without your consent.

1.Contact Information