WHISTLEBLOWER DISCLOSURE FORM

If you wish to report any concern related to misconduct or wrongdoings, please fill in the form below. We assure that your identity will be protected.

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Who are you reporting against?
Employee of Bank Islam Group
Executive Leadership (Chairman of the Board of Directors, Group Chief Executive Officer, Group Chief Integrity & Governance Officer) & Any member of Integrity & Governance Dept.
Board Member & Group Shariah Supervisory Council
Are you an employee of Bank Islam Group?
Name
NRIC No.
Company
Position
Email Address
Office No. (if any)
Mobile No.

Nature of alleged misconduct (Please tick the appropriate box)

Bribery, receiving and/or giving kickbacks
Fraud or dishonesty
Abuse of position
Abuse of the Group’s property and information
Forgery or alteration of any documents belonging to the Group, its customers, another financial institution(s), or agents of the Group
Embezzlement or theft
Conflict of interest
Poor or unethical sales practices, including mis-selling and insider trading
Any other actual or suspected breach of any other laws
Breach of the Bank’s Code of Ethics and Conduct and any other policies
Breach of BNM/ Securities Commission Malaysia / Bursa Malaysia’s policy / regulatory documents
Abetment to commit any of the above wrongdoing
Detrimental action taken against Whistleblower or persons closely associated with Whistleblower
Improper behaviour / other matters that may breach the Group’s and/ or subsidiary’s Code of Ethics and Conduct and/ or actions that may damage or negatively impact the Group’s financial wellbeing and branding
Date and time of alleged incident
Place of Alleged Incident
Name of Person (s) Involved
Designation of Person (s) Involved
Division/Department of Person (s) Involved
Witness (if any)
Details of the alleged misconduct

Please attach any other information/evidence (eg. document,photograph,etc) together with the Whistleblower Disclosure Form

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Allowed file types: PDF, Word (.doc/.docx), Excel (.xls/.xlsx), JPG, JPEG, PNG, GIF, BMP, TIFF. Maximum size: 2 MB.

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I hereby declare that all the information furnished herein is made voluntarily and are true to the best of my knowledge and free from any malicious intent.
I acknowledge that Bank Islam Group reserves the rights to use the information and material provided strictly for the purpose of acting on this disclosure.