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Reporting Compliance Violations Form

Please use this form if you wish to report a violation or suspected violation of the Cotecna’s Compliance Code. This report will be treated in the strictest confidence and thoroughly investigated in accordance with Cotecna’s Compliance Procedures.

1. Your Details (your personal details are optional, as stated above)
Would you like to report anonymously, so that your identity remains confidential?
Last Name:
First Name:
Address:
Country:
Home Phone:
Work Phone:
Mobile Phone:
E-mail:  
If you wish to be contacted by us, please provide contact details: (e.g. time of day to be contacted)  
Would you like to receive feedback once investigation has been carried out?  

2.0 : Violation Report
Location of violation (city, country):  
Date and time of violation:
Please describe the violation:

How did you discover this violation?



Upon request, would you be able to provide us with proofs of violations (documents...)?

Thank you for reporting this violation. This report will be investigated even if you did not provide us with your identity.