Child Labor Incident Report Form
Use this form to report suspected or confirmed child labor incidents with the key facts needed for follow-up.
Incident Details
Date of Incident
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time of Incident
*
Hour Minutes
AM
PM
AM/PM Option
Location of Incident
*
Type of Incident Observed
*
Suspected child labor
Confirmed child labor
Unsafe work for a minor
Forced labor indicators
Other relevant incident
Child and Circumstances
Approximate age of child
*
Observable description of the child
*
Nature of work or task observed
*
Is the incident ongoing or isolated?
*
Ongoing
Isolated
Unknown
Reporting and Follow-up
Immediate action taken
Reporter name and contact information
*
First Name
Last Name
Submit Report
Should be Empty: