KPMG ETHICSLINE

KPMG Forensic has been engaged by its client ("Client") to provide KPMG EthicsLine, an independent conduit for employees of Client or Client's affiliates, or parties with whom Client or Client's affiliates have business dealings, to report any fraud or misconduct that such employees or parties suspect is happening in Client organisation.

All reports received will be referred to Client organisation for follow-up actions or investigations.

While you are encouraged to disclose your identity, this is not mandatory. We respect your desire for anonymity, and to preserve the confidentiality of the information you provide. However, our ability to contact you if required to seek further clarification or information may play a role in determining the effectiveness of any investigation.

1.1 About which company would you like to make this report?

Company name: (*)

1.2 Where is the company located?

Department / Section:

Address:

City:

Province:

Country:

1.3 Please indicate your relationship to the company reported.

Contractor
Customer
Employee
Supplier
Other

1.4 Would you like to provide your name and contact details?

I would like to provide my name and contact information to KPMG and the company.
I would like to provide my name and contact information to KPMG only.
I would like to remain anonymous.

Name

Contact information

I acknowledge that I have read and understood the terms stated in the

Online Privacy Statement