Whistleblower Form

This form is to be completed by person to who wishes to report any misconduct or suspected breach of code of ethics; laws and regulations; and company’s policies and procedures. Please note that you may be called upon to assist in the investigation, if required

Information on Whistleblower
Information on Person Alleged
Information on Witness (If any)
Details of Allegations
Have you raised your concern to any other person / department/ authority? (Tick whichever applicable)
DECLARATION

I hereby declare that all information given herein is made in good faith and voluntarily to the best of my knowledge and I will ensure that my participation in this matter will be kept confidential. I do understand that PAAB will use the information, document and material provided throughout the investigation process.

I further agree that the information provided herein may be forwarded to a department/ authority/ enforcement agency for purposes of investigation. I fully understand that by signing this Form, I will be entitled to Whistleblower protection from the PAAB as set out in PAAB Whistleblowing Policy.

I also fully understand that in the event I have made this report non-based allegations or in bad faith, the Whistleblower protection stated in PAAB Whistleblowing Policy will not be applicable to me and I may be subject to disciplinary or legal proceedings by PAAB.

Signature