Whistleblower form

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Whistleblower form

Please provide the following details for any suspected serious misconduct or any breach or suspected breach of law or regulation that may adversely impact the Company. Please note that you may be called upon to assistin the investigation, if required.

Note: Please follow the guidelines as laid out in the Whistleblowing Policy

Reporter's contact information

(This section maybe left blank if the reporter wish to remain anonymous)

Suspect's Information

Witnesses's information (if any)

Complaint: Briefly describe the misconduct /improper activity and how you know about it. Specify what, who, when, where and how. If there is more than one allegation, number each allegation and use as many pages as necessary.