1 Please provide name of the business that the complaint relates to.
1.1 Please specify:
2 How are you associated with the company?
Employee
Director
Vendor/supplier
Other
2.1 Please specify:
3 Your details:
I would like to share my name and contact information
I would like to share my information with KPMG, but not with the company
I would like to remain anonymous
3.1 Name:
3.2 Contact number:
4 Please select the applicable incident type(s) from the list below that best describes the issue(s) you are reporting. Please note that multiple issues can be selected
Acceptance of gifts and entertainment
Bribery and corruption
Concurrent employment
Conflict of interest
Discrimination
Harassment of any nature (other than sexual harassment)
Inappropriate use of social media
Incorrect financial reporting
Insider trading
Misappropriation of company assets/resources
Mishandling of confidential information
Procurement fraud
Sexual harassment
Tax fraud
Victimisation or bullying
Violation of the environment health and safety guidelines
Others
4.1 Please specify:
5 Please provide name, designation and department of the person(s) involved?
Name
Designation
Department
Individual 1
Individual 2
Individual 3
Individual 4
6 When did the incident occur?
(Please provide tentative date if you do not know the exact date)
7 Please confirm the location of the incident
8 How did you find out about this incident?
9 How long has this been occurring for?
Less than a month
1 - 6 months
6 - 12 months
Greater than 12 months
9.1 Please specify:
10 Please provide a detailed description of the incident. To enable your company to act on your complaint, you are requested to provide specific information where possible, including names, location, date, time, etc. Please note that this field is limited to 5,000 characters.
11 Do you have any evidence in support of your allegations?
Yes
No
11.1 If yes, please provide details of the evidence: