Unsafe Condition & Unsafe Acts (UCUA) Form
Health, Safety & Environment (HSE)
Kindly fill in the following form
* Mandatory fields to fill
Contact Detail
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Full Name
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Designation
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Email Address
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Phone Number
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Head Office/Branch
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Head Office (Menara Bumiputra)
Jalan Melaka
Jalan Ipoh
Sungai Besi
Jalan TAR
Putrajaya
Taman Melawati
Alam Damai
Bandar Baru Bangi
Batu Caves
Glenmarie
Kajang
Klang
Petaling Jaya
Rawang
Laman Seri
Shah Alam, PKNS
Subang Jaya
Universiti Islam Antarabangsa
Ampang Point
Puncak Alam
Kangar
Alor Setar
Bayan Baru
Kulim
Parit Buntar
Seberang Jaya
Sungai Petani
Taiping
Souq Al Bukhary
Lebuh Pantai
Ipoh
Seri Manjung
Port Dickson
Seremban
Batu Pahat
Johor Bahru
Johor Jaya
Kluang
Kulai
Melaka
Tmn. Cheng Baru
Segamat
Taman Universiti
UTHM
Kota Tinggi
Gemas
Muar
Jalan Sultan Yahya Petra
Kota Bharu
Kuala Terengganu
Kok Lanas
Gua Musang
Jeli
Kg. Raja
Tanah Merah
Kuantan
Mentakab
Pekan
Temerloh
Kemaman
Indera Mahkota
Bintulu
Kota Kinabalu
Kuching
Labuan
Miri
Tawau
Sandakan
Division
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Division
Banking Operations Division
Branch Operations Department
Commercial Banking Division
Corporate Banking Division
Credit Recovery Division
Digital Banking Department
Finance Division
Group Legal Secretariat Division
Human Capital Division
Internal Audit Division
Investment Banking Division
Management Office
Marketing and Corporate Communications
Muamalat Invest Sdn Bhd
Regulatory Advisory and Compliance Division
Retail Banking Division
Risk Division
Strategy Division
Technology Division
Transaction Banking Division
Treasury and Capital Markets Division
Jalan Melaka
Department
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Choose department
Operational, Control, Process & Product
Credit Operations
Customer Service
Payment and Treasury Operations
Trade Operations
Wholesale Banking Shared Service Center
Location of Unsafe Act or Unsafe Condition
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State Floor level and specific area
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Please describe exact location if not stated above:
Category of Observation
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*Please select either one
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Select Observation Type
Select an option
Unsafe Condition
Unsafe Act
Other
Select Unsafe Condition
Select an Unsafe Condition
Dangerous machine / equipment condition
Defective tools / equipment
Slippery floor surface
Exposed live wire (Electrical)
Malfunctioning safety devices
Improper working position
Fire & explosion hazards
Risk of falling object (overhead risk)
Inadequate warning systems
Sharp edges / surface
Select Unsafe Act
Select an Unsafe Act
Operating equipment / machine without authorization
Not following SOPs while working
Not wearing proper Personal Protective Equipment (PPE)
Horseplay at workplace
Incompetence
Illness / Fatigue
Speeding inside premise
Working under the influence of alcohol and/or other drugs
Please specify your observation
Picture Attachment
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Kindly attach pictures as evidence
Total max size of pictures must be less than 10MB
File(s)
Description
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Please explain the issue in detail
Immediate Action Taken by Observer
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Please state if there is any action taken immediately
If no action taken, please state none
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