Template No.: T-TK017
Template Title: Response Tracking Form (Institution “Silent” Response)
Related Research Case IDs / Cluster: TK-017 / Cluster C (Institution-Building, Letters, MoUs) + Cluster F (Conflict, Risk, Escalation)
Linked Templates / Policies: T-TK004 External-Claim Verification SOP; T-TK006 Publication Approval Workflow; T-TK005 Public Correction Procedure (if rumor grows); Incident Reporting Form; Data Protection & Confidentiality Policy; Conflict Resolution & Security SOP
Date of form: ____ / ____ / ______
Prepared by / Role: _______________________
Office / Unit: ____________________________
Country / Location: _______________________
Confidentiality Level:
Internal only [ ] Restricted [ ] Sacred-Restricted / Sensitive [ ]
Use of this form (tick):
New case / action [ ] Follow-up [ ] Annual review [ ] Archive only [ ]
1) Purpose
Use this form when HSWAGATA sends a letter or report to an institution (government, university, lab, hospital, police, monastery council, etc.) and the response is silent (no reply), unclear, or delayed.
Goal:
Keep clear proof of submission and follow-ups.
Prevent “we never received it” problems.
Support calm and fair escalation.
2) Case and request summary
Tracking ID: TK017--
Related case (if any): ____________________________
Institution name: __________________________________________
Department/unit (if known): ________________________________
Address: _________________________________________________
Main contact person (if known): ____________________________
Public official phone/email used: ___________________________
Request type (tick):
Verification request [ ] Complaint/report [ ] Meeting request [ ] Evidence submission [ ] MoU request [ ] Other: ______
Short request summary (1–2 lines, facts only):
Risk level:
Low [ ] Medium [ ] High [ ] Critical [ ]
Reason (tick): Relic risk [ ] Public rumor risk [ ] Safety risk [ ] Legal risk [ ] Other: ______
3) Outgoing letter details (the “master record”)
Letter title/subject: ______________________________________
Letter reference number (HSWAGATA): ________________________
Date on letter: ____ / ____ / ______
Signer (name/role): ________________________________________
Attachments included (tick): Evidence list [ ] Photos [ ] Reports [ ] Receipts [ ] Other: ______
Privacy check done (no personal data / sacred-restricted leaks): Yes [ ] No [ ]
File name stored (standard): TK017_YYYYMMDD_Institution_Subject_V1
Stored at secure location: __________________________________
4) Submission method and delivery proof (must complete)
Submitted by (name/role): __________________________________
Submitted date/time: ____ / ____ / ______ _______ (time)
Method (tick one or more):
Hand delivered [ ] Registered post [ ] Courier [ ] Email [ ] Online portal [ ] Other: ______
Delivery proof type (tick):
Receipt/stamp copy [ ] Tracking number [ ] Email sent screenshot [ ] Portal confirmation [ ] Witness signature [ ]
Delivery proof ID / tracking number: ________________________
Delivery proof file name: _________________________________
Status of delivery proof:
Confirmed delivered [ ] Pending [ ] Unknown [ ] Returned [ ]
5) Follow-up schedule (default plan)
Default follow-up steps (you can adjust):
Follow-up 1: 7 days after submission
Follow-up 2: 14 days after submission
Follow-up 3: 21–30 days after submission (escalation level)
Follow-up 1 planned date: ____ / ____ / ______
Follow-up 2 planned date: ____ / ____ / ______
Follow-up 3 planned date: ____ / ____ / ______
6) Response tracking log (fill every time)
Use short facts. Attach proof (email screenshots, call notes).
| Step | Date | Time | Action (sent/call/visit) | Who did it | Who was contacted | What was said (short) | Proof saved? (Y/N) | Outcome |
|---|---|---|---|---|---|---|---|---|
| 1 | Initial submission | |||||||
| 2 | Follow-up 1 | |||||||
| 3 | Follow-up 2 | |||||||
| 4 | Follow-up 3 / escalation |
Outcome options (use these words):
No reply (silent) / “Received” only / “Under review” / “Need more info” / “Wrong office” / “Rejected” / “Closed” / “Meeting agreed”
7) If still silent (escalation ladder)
Tick what you did:
Level A — Confirm receipt (no conflict)
Ask for a case/reference number [ ]
Ask for the correct office if wrong office [ ]
Resend the letter with delivery proof attached [ ]
Level B — Written escalation (formal)
Send a second letter to a higher desk/supervisor [ ]
Copy the same institution oversight/complaints unit (if exists) [ ]
Request written reply by a clear date: ____ / ____ / ______ [ ]
Level C — Board/security/legal trigger (High/Critical)
Board delegate informed [ ] Date: ____ / ____ / ______
Security review opened [ ]
Legal advice requested (if needed) [ ]
Public statement needed? Yes [ ] No [ ] (If yes, use T-TK006 + T-TK005)
Escalation reason (facts only):
8) “Silence outcome” decision (internal)
Choose one:
Silence acceptable (low risk; keep record only) [ ]
Silence not acceptable (continue escalation) [ ]
Open Incident Report because risk is increasing [ ]
Move to mediation/partner approach (if suitable) [ ]
Other: ____________________________________ [ ]
Decision made by (name/role): ______________________________
Date: ____ / ____ / ______ Signature: ______________________
9) Closure section
Final status (tick one):
Reply received and archived [ ]
Institution confirmed “no action” [ ]
Case moved to new office [ ]
Case still silent (kept open) [ ]
Case closed by HSWAGATA (record saved) [ ]
Closure note (1–2 lines):
Attachments list:
Letter copy [ ] File name: ____________________________
Delivery proof [ ] File name: __________________________
Follow-up proofs [ ] File name(s): ______________________
Response letter (if any) [ ] File name: __________________
Filed by: _______________________ Date: ____ / ____ / ______
Reviewed by (Head/Board delegate): ______________ Date: ____ / ____ / ______
