Whistleblowing Form

Please select the company you want to report about and describe your relation to the company.

The more information and details you provide, the better an investigation can be conducted. Please give a detailed description of the exact event, what you saw, heard or witnessed. When reporting an incident, please be as specific and objective as possible and do not include bias information.

a. Describe the incident.

b. Were you personally involved in the incident?

Yes

c. Specify the name(s) of the person(s) involved in the incident.

I prefer not to say

e. Specify the timeframe in which the incident happened (please enter a specific date or time range).

From

Until

The incident is still going on today.

f. How long have you been aware of the incident?

g. Where did the incident take place? (specify the exact location/address)

h. Did anyone else witness the incident?

Yes

i. Is anyone else aware of the incident?

Yes

j. If you have any supporting documents, please attach them here. You can upload all file types. You can also upload multiple files.

You may disclose your identity, which shall be kept conﬁdential. In case you choose to report anonymously, you can leave this section empty.

Name:

Email address:

Country

Phone Number

By ticking this box, I declare I filled out this form as complete and accurate as possible and in accordance with the principles of honesty and good intent. *