The disclosure is against:
Staff [excluding President/ Chief Executive Officer (CEO) and Chiefs of Divisions (CoDs)]
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Department (of Alleged Person)
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Estimated Value Involved (please state the currency), if any
Supporting Evidence, if any
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Company Name
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Date
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I hereby acknowledge that all the information given herein is made in good faith, voluntarily and is true to the best of my knowledge. I will ensure that my participation in this matter and all the information provided will be kept confidential. I do understand that the Company will process the information and material provided in the course of managing the disclosure.
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