KPMG Ethics Line
   
 

 

 
1.1 About which company would you like to make this report?
 
Company name:
 
1.2 Where is the company located?
 
Department / Section:
Address:
City:
State /Province:
Country:
 
1.3 Please indicate your relationship to the company reported.
 
Select Relationship:
 
 
1.4 Would you like to provide your name?
 
Select Response:
 
 
2.1 Please select the applicable Incident Type from the list below that best describes the issue(s) you are reporting:
 
Select Incident Type:
 
 
3.1 Do you know the name of the person(s) or organisation(s) involved?
 
Select Response:
 
 
3.2 Do you want to add another involved party?
 
Select Response:
 
 
3.3 Has management been notified?
 
Select Response:
 
 
4.1 When did the incident occur?
 
Select Date:
 
4.2 Where did this incident occur?
 
Specify Location:
 
4.3 How do you know about this incident?
 
Provide Details:
(Maximum characters: 4000)
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4.4 Is any supporting information available?
 
Supporting Information:
 
4.5 Please provide a detailed description of the incident. Provide as much detail as you are able to, using times, dates, places and names whenever possible. Indicate WHO did it? WHAT did the person do? WHERE did the person do it? WHEN did the person do it? HOW did the person do it? Please note that this field is limited to 5,000 characters.
 
Incident Details :
(Maximum characters: 4000)
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4.6 Do you know whether this incident will reoccur:
 
Select Response:
   
Your Email:
   
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