Chrysal Hotline

Please provide information as follows:

(* required fields)

Specific Chrysal Organization*

Location where incident occurred:

What is you relationship to the Company?*

Do you wish to remain ANONYMOUS for this report?*

If you want The Company to know your identity, please complete the following:

Your phone number

Your email address

Best time for communication with you

If you want The Company to not know your identity, please complete the following:

Preferred way of communication and contact details

Please note: If you want to remain anonymous we encourage you to setup a special email account for communication

Report

Please identify the persons involved. Example: John Doe, Director of Chrysal

Person #1*

Person #2

Person #3

Have you previously reported this to management, and if yes, to whom?*

Please provide the approximate date and time this occurred or began?*

How did you become aware of this?*

" Please describe your concern, including: - Whether has occurred once or is recurring; - The people involved; - Detailed description of the issue; - If you wish to remain anonymous, please ensure that you do not provide details that will reveal your identity; - The reason you are reporting this issue; Please take your time and provide as much detail as possible, but exercise care to not provide details that may reveal your identity unless you wish to do so. It may be important to know if you are the only person aware of this situation"

If you are reporting this anonymously

If you have submitted this form anonymously you will receive a log number after submission. This which allows you to perform inquiry about the status of the investigation either by phone or by email. In case the reporter does not check this status within 90 days after the date of the initial report, the investigation, if started, will be terminated.

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