Prepared in accordance with Section 21 & 22 of the Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act, 2013 and Rule 14 of the POSH Rules, 2013.

1. Organization Details

Name of the Organization
Registered Address
Contact Details (Email/Phone)
Name of Employer / Head of Organization
Reporting Period	1st January 20__ to 31st December 20__
Total Number of Employees

2. Internal Committee (IC) Details

As per Section 4 of the POSH Act, the Internal Committee for the reporting period consisted of the following members:

Name	Designation/Role (Presiding Officer/Member/External Member)	Department/Organization	Contact Details

3. Complaints Summary

Number of complaints received during the year
Number of complaints disposed of during the year
Number of cases pending for more than 90 days
Number of workshops/awareness programs conducted
Nature of action taken by the employer/District Officer
Remarks/Observations (if any)

4. Preventive and Awareness Measures

Details of awareness sessions, employee sensitization programs, or IC trainings conducted during the reporting period:

• Awareness sessions for employees: _______________________
• Training programs for IC members: _______________________
• Display of POSH policy at workplace: Yes / No
• Online/Offline grievance mechanism available: Yes / No

5. Declaration by Presiding Officer

I, ____________________________________________, Presiding Officer of the Internal Committee, hereby declare that the information provided above is true and correct to the best of my knowledge and belief.

Place: ___________________________

Date: ___________________________

Signature: ___________________________

Name: ___________________________

Designation: Presiding Officer, Internal Committee