COMPLAINT REGISTRATION FORM

* Any information you have about the facts is valid for proper investigation, but remember that the integrity of what you are reporting is the most important factor in achieving a fair and impartial analysis.

* Regarding your identity, you prefer

I want to identify myself

I do not want to identify myself

* Please, specify Please, describe what kind of relationship you have with the company

* Regarding the facts that you are denouncing:

When the incident occurred, began to or will occur?

* What location the incident happen?

* Describe in detail the location where the incident occurred If possible, please indicate the location and area where the facts you want to record occurred

* What activity / line of service involved? Which ENGIE activity affected / related to the incident you want to report?

* Which type of accusation best describes the facts you are reporting?

Indicate the person or the people involved in the event, if possible, their full names, position / function and the place of organization where the incident occurred

* Full name

* Function

* Participation in the incident

* Would you like to indicate another person?

Yes

No

* Description Describe the incident in the most detailed way as possible

Any suggestions for resolving the situation? If you have any suggestions on how to treat the problem, please describe it

* Regarding with the number of occurrences

Attached protocol number If you have done an earlier report on this same event and want to link the records, please indicate the protocol number

Financial value If you are aware of the financial amounts involved, please indicate the amount

You can use the space below to share any evidence you may have: Choose files to send

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