CODE OF CONDUCT REPORTING FORM

The PureCircle Code of Conduct on-line reporting form allows you to raise concerns related to the Code of Conduct or other potential violations of laws, regulations, or company policies in a confidential manner. The concern raised on this webpage are transmitted to the Head of Finance (as Compliance Officer).

Please provide the following details for any suspected misconduct or breach of law, regulation, or company policy. Please note that while you may report anonymously, it would be most helpful if you identify yourself so that you may be called upon to assist in the investigation, if required.

REPORTER'S CONTACT INFORMATION (This section may be left blank)

NAME
DESIGNATION
DEPARTMENT / AGENCY
LOCATION
EMAIL-ADDRESS
CONTACT NUMBER

SUSPECT'S INFORMATION

NAME*
DESIGNATION*
DEPARTMENT / AGENCY*
LOCATION*
EMAIL-ADDRESS*
CONTACT NUMBER*

WITNESSES'S INFORMATION (if any)

NAME
DESIGNATION
DEPARTMENT / AGENCY
LOCATION
EMAIL-ADDRESS
CONTACT NUMBER

COMPLAINT

Briefly describe the suspected misconduct / improper activity and how you know about it.

What misconduct / improper activity occurred ? *
Who committed the misconduct / improper activity ? *
When did it happen and when did you notice it ? *
Where did it happen ? *
Is there any evidence that you could provide us ?
Are there any other parties involved other than the suspect stated above ?
Do you have any other details or information which would assist us in the investigation ?
Any other comments ?