MOBIS - Whistleblowing form MCZ-OS

1. Contact details of the Whistleblower: *

First name and surname:

Date of birth:

Telephone:

E-mail:

Please enter email value in format 'mymail@domain.com'.

Other (ID number, address etc.):

Which time do you prefer to be contacted if necessary and what method of contacting do you prefer (e-mail, telephone)?

The company Mobis Automotive System Czech s.r.o, ID: 03758397, č. p. 375, 742 51 Mošnov, as a controller of personal data, will process Personal data provided by you (or obtained from public sources), in accordance with the General Data Protection Regulation (EU) 2016/679. Details of personal data processing can be found here.

I wish to report anonymously

Please, select answer.

Warning:

Warning: In the event of an anonymous notification, carefully note and keep the return link. Once you have logged in with this return code, you can track the status of your notification and its processing. Anonymous notifications do not fall under the regime of the Whistleblower Protective Act (hereinafter referred to as “ZOO”). Mobis will therefore not deal with notifications within the same time limits set by the ZOO, does not guarantee that an anonymous notification can be properly investigated, and is unable to provide protection from retaliation (as it is not possible to determine who needs to be protected). Mobis is also not obliged to inform the anonymous whistleblower about the progress and result of the investigation to the extent provided by the ZOO.

2. What is your relation to company Mobis Automotive System Czech s.r.o. (herein after referred as “Mobis”)? *

Employee
Supplier
Other (intern, volunteer, job applicant, ...)

Please, select answer.

Describe which other relation you have towards the company Mobis: *

3. Which area of law is the reported incident related to? *

Please, select answer.

Describe which other area is relevant to the reported event: *

4. Content of the statement:

Please answer the questions below truthfully and completely. If you provide knowingly untrue information, you are not entitled to claim protection from retaliation under the Whistleblower Protection Act.

What action is the subject of the reported event? *

When and where did the reported event take place, or since when it is taking place? Is the reported event already completed or is the event still in progress? *

Was another person present to the reported event, or are you aware of any person who could tell us more about the reported event?

No
Yes

If yes, provide contact details for this person and what information he/she could provide us: *

Are you aware of any investigation that has already been initiated by an external body or Mobis on the reported event?

No
Yes

If yes, please describe which entity initiated the investigation and provide contact details: *

Have you already notified anyone of the reported event?

No
Yes

If yes, please provide the names of these persons, including their reaction (in particular, whether or not they have taken steps to investigate the reported event): *

5. Attachments:

Please upload all documents available to you. Documents can be uploaded in .pdf, .jpeg, .doc, .mp3, .mp4, .avi format.

Uploading files helps us to investigate the event, thank you!

6. Processing of announcement, progress and results of investigation:

Warning:

We will inform you about the progress and result of the investigation by a report on the web portal. A unique return web link will be sent to your email address if it has been provided. If the notification was made anonymously or no email address was provided, please note and carefully keep the unique return web link generated.

The investigation will be done by the competent persons who will inform you about the result of the investigation within 30 days via the web portal or, if an e-mail has been provided, by e-mail. In factually or legally complex cases, the competent persons are entitled to extend the time limit for the investigation, in which case you will also be informed of the extension of the time limit.

You will not be informed about the receipt of the announcement, the progress and the result of the investigation if you explicitly request it below.

Do you want us to inform you about the receiving of the announcement, result of the investigation and taken corrective measures?

Yes
No
I want to be informed only about:

We will treat the information and data you provide us in this statement as confidential.

I understand to the information about personal data processing. here *

Please confirm that you understand the information regarding the processing of personal data.