Scientology Report Form

This can be found here:

https://www.rtc.org/reports/form/index.html?locale=en

INTRODUCTION

THE RELIGION OF SCIENTOLOGY

THE GUARANTOR OF SCIENTOLOGY’S FUTURE

MR. DAVID MISCAVIGE CHAIRMAN OF THE BOARD RELIGIOUS TECHNOLOGY CENTER   INTERNATIONAL SCIENTOLOGY EVENTS OPENINGS OF NEW IDEAL CHURCHES OF SCIENTOLOGY

SEND A REPORT TO RTC

MATTERS OF RTC CONCERN

CONTACT

INTRODUCTION TO THE RTC ELECTRONIC REPORT FORM

MATTERS OF RTC CONCERN: ETHICS TECH ADMIN

The Internet has grown to an estimated 940 million users, which continues to escalate on a daily basis. As there are tens of thousands of Scientologists who have access to the Internet, RTC has set up an “e-form” (electronic form) line to give everyone the option and ability to send reports to RTC on Matters of RTC Concern via the Internet.

“E-form” is simply an electronic form of traditional paper forms that are filled out on a computer and are sent electronically in just a few minutes from anywhere in the world.

You will also find a description of what the Matters of RTC Concern are, with detailed listings of these in the Matters of RTC Concern section.

The report form on the next page is easy to fill in, and allows one to give full details of what one is reporting on per HCO Policy Letter 22 July 1982R, Revised 9 August 2000, KNOWLEDGE REPORTS or in Chapter 9, “Ethics Reports”, under the section KNOWLEDGE REPORTS in the book Introduction to Scientology Ethics by L. Ron Hubbard.

RTC ELECTRONIC REPORT FORM Please enter your information in the boxes below: * Indicates required field * First Name: * Last Name: * Street Address: * City: State (US only):    AK   AL  AR  AS  AZ  CA  CO  CT  DC  DE   FL  FM  GA  GU  HI  IA  ID  IL  IN   KS  KY  LA  MA  MD  ME  MH  MI  MN   MO  MP  MS  MT  NC  ND  NE  NH  NJ   NM  NV  NY  OH  OK  OR  PA  PR  PW   RI  SC  SD  TN  TX  UT  VA  VI  VT   WA  WI  WV  WY  State/Province: (Non-US only) * Zip/Postal code: * Country:  Select one  United States  Afghanistan  Albania  Algeria  American Samoa  Andorra  Angola  Anguilla  Antarctica  Antigua and Barbuda  Argentina  Armenia  Aruba  Australia  Austria  Azerbaijan  Bahamas  Bahrain  Bangladesh  Barbados  Belarus  Belgium  Belize  Benin  Bermuda  Bhutan  Bolivia  Bosnia and Herzegovina  Botswana  Bouvet Island  Brazil  British Indian Ocean Territories  Brunei Darussalam  Bulgaria  Burkina Faso  Burundi  Cambodia  Cameroon  Canada  Cape Verde  Cayman Islands  Central African Republic  Chad  Chile  China, People's Republic of  Christmas Island  Cocos Islands  Colombia  Comoros  Congo  Cook Islands  Costa Rica  Cote D'ivoire  Croatia  Cuba  Cyprus  Czech Republic  Denmark  Djibouti  Dominica  Dominican Republic  East Timor  Ecuador  Egypt  El Salvador  Equatorial Guinea  Eritrea  Estonia  Ethiopia  Falkland Islands  Faroe Islands  Fiji  Finland  France  France, Metropolitan  French Guiana  French Polynesia  French Southern Territories  FYROM  Gabon  Gambia  Georgia  Germany  Ghana  Gibraltar  Greece  Greenland  Grenada  Guadeloupe  Guam  Guatemala  Guinea  Guinea-Bissau  Guyana  Haiti  Heard Island And Mcdonald Islands  Honduras  Hong Kong  Hungary  Iceland  India  Indonesia  Iran  Iraq  Ireland  Israel  Italy  Jamaica  Japan  Jordan  Kazakhstan  Kenya  Kiribati  Korea, Democratic People's Republic of  Korea, Republic of  Kuwait  Kyrgyzstan  Lao Peoples Democratic Republic  Latvia  Lebanon  Lesotho  Liberia  Libyan Arab Jamahiriya  Liechtenstein  Lithuania  Luxembourg  Macau  Macedonia  Madagascar  Malawi  Malaysia  Maldives  Mali  Malta  Marshall Islands  Martinique  Mauritania  Mauritius  Mayotte  Mexico  Micronesia  Moldova  Monaco  Mongolia  Montserrat  Morocco  Mozambique  Myanmar  Namibia  Nauru  Nepal  Netherlands  Netherlands Antilles  New Caledonia  New Zealand  Nicaragua  Niger  Nigeria  Niue  Norfolk Island  Northern Mariana Islands  Norway  Oman  Pakistan  Palau  Panama  Papua New Guinea  Paraguay  Peru  Philippines  Pitcairn  Poland  Portugal  Puerto Rico  Qatar  Reunion  Romania  Russian Federation  Rwanda  Saint Helena  Saint Kitts and Nevis  Saint Lucia  Saint Pierre and Miquelon  Saint Vincent and The Grenadines  Samoa  San Marino  Sao Tome and Principe  Saudi Arabia  Senegal  Seychelles  Sierra Leone  Singapore  Slovakia  Slovenia  Solomon Islands  Somalia  South Africa  South Georgia and Sandwich Islands  Spain  Sri Lanka  Sudan  Suriname  Svalbard and Jan Mayen  Swaziland  Sweden  Switzerland  Syrian Arab Republic  Taiwan  Tajikistan  Tanzania  Thailand  Togo  Tokelau  Tonga  Trinidad and Tobago  Tunisia  Turkey  Turkmenistan  Turks and Caicos Islands  Tuvalu  Uganda  Ukraine  United Arab Emirates  United Kingdom  United States  United States Minor Outlying Islands  Uruguay  Uzbekistan  Vanuatu  Vatican City State  Venezuela  Vietnam  Virgin Islands (British)  Virgin Islands (U.S.)  Wallis And Futuna Islands  Western Sahara  Yemen  Yugoslavia  Zaire  Zambia  Zimbabwe  E-mail: * I am a Non-Scientologist Public Scientologist Staff Member Date of Birth: Any additional information you want to provide about yourself: IMPORTANT MESSAGE This report is to include facts; a fact is defined in HCO PL 26 April 1970R, Revised 15 March 1975, THE ANATOMY OF THOUGHT as “A FACT is something that can be proven to exist by visible evidence. An OPINION is something which may or may not be based on any facts.” If the report concerns something that is suspected or not a fact as per the definition above, please state this in your report and also note: TIME, PLACE, FORM and EVENT. * I am reporting on: An org or portion of an org Person(s) Other Copies of this report go to: * Type of Report:    Knowledge Report  Alter-Is Report  Error Report  Misdemeanor Report   Crime Report  High Crime Report  Technical Alter-Is Report  Technical Noncompliance Report  Things That Shouldn't Be Report  * Type your report: I attest that the report is true and sent from the person it is said to be being sent from: Name:  1. You can now preview your report and make corrections as needed in the form above.      2. Print copies of this report for anyone you have info'ed on it, as they will not be automatically forwarded by the electronic form. 3. Send your report.