Ethics Channel Form

Fields marked with an asterisk (*) are required.

Submission of a complaint

Type of complaint*

Contact details

Name

Surnames

National Identity Document or Tax Identification Number

Relation with COMERBAL, S.A. (employee, supplier, client, subcontractor, partner, etc.)

If applicable, position at COMERBAL, S.A.:

Contact details of the person reporting (email address, home address, telephone number or other) so that the Ethics Channel Manager can send notifications or communications:

Approximate dates of the start and, where applicable, the end of the event:

Is it still happening?

Yes No

Identity of the person/s reported:

Details of the first person reported

Name

Surnames

National Identity Document or Tax Identification Number

Position/Area/Department in which the events being reported occurred*:

Add person reported (optional)

Name

Surnames

National Identity Number or Tax Identification Number

Position/Area/Department where the events being reported occurred*:

Clues, clarifying explanations or evidence on which the information is based. All available pieces of evidence must be provided, or it must be indicated where and how to obtain them (e.g. witnesses, documents, records, etc.).

Attached documentation

Request for an in-person complaint

Would you prefer to request a personal interview directly with the Head of the System at COMERBAL, S.A.?

Yes No

(If you have ticked the YES box, please fill in the ‘Informant's contact medium’ box)

When? (date)

When? (time)

ETHICS CHANNEL FORM

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