Compliance Form

     

Description possible violation:

     

When the alleged violation occurred: (Please enter date)

 
     

Person(s) involved (Please separate names with a comma):

 
     

How did you come to learn of the incident/practice described?

 
     

Do you have any evidence to prove the above allegations?  If so, please describe:

 
     

Would you be willing to discuss these allegations with the compliance officer, a member of Board of Trustees, or an attorney for the company? 

 



     

If you have discussed these allegations with anyone else: Who?  (Please separate names with a comma):

 
     

Do you have any further information to provide or any suggestions for verifying the allegations described?

 
     

Are you aware of any other individuals who may be able to provide further information regarding the allegations?

 
     
     

 


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