Whistle Blowing Form

REPORT OF IMPROPER CONDUCT,
WRONGDOINGS, CORRUPTION, FRAUD,
WASTE OR ABUSE OF POWER

To :

Executive Directors
Mr Kuo Jen Chang, Kuo Jen Chiu or Ms Mary Henerietta Lim
Evergreen Fibreboard Berhad
PLO 22 Parit Raja Industrial Area,
86400 Batu Pahat, Johor, Malaysia
Tel : 607 - 4541933
Fax : 607 -4542933

or

Independent Director (Ms Nirmala Doraisamy)
Email address: [email protected]

or

The Company Secretary
Ms Julie Leong
Email address : [email protected]
1. Name of the person(s) you are reporting about :
2. Department in which that person works :
3. Please provide a summary of the alleged improper conduct, wrongdoings, corruption, fraud, waste or abuse of power that you are reporting :
4. Please attach documentations to support your claim :
5. Provide information on relevant witnesses, if any, including email, contact number and/or the best way to get in touch with them :
Witness #1
Name: Email: Phone No.:
Witness #2
Name: Email: Phone No.:
6. Please provide dates that the alleged activity took place :
7. Location of where activity took place :
8. Please provide any other information you may find relevant :
Note :
We will not document information concerning your name if you wish to remain anonymous;
however, if you do not want to be anonymous please provide information below:-
Name:
Contact No:
Email Address:

*If you decide to remain anonymous, please contact us within 7 working days of your report, as we may need more information concerning the alleged activities reported.