ANTI-TRUST INFORMATION FORM Anti-trust Information Form A. Compliance Program Process Program Elements Due Diligence Training Certifications Export Controls / Anti-trust Communications Tone-at-the-top Hospitality, Gifts, Donations, other HelpLine Data Privacy Investigations B. Business Related Information B1. Business Services / Unit Program Evaluation Review, Response OtherOther B2. Region Involved North America Latin America Europe / Middle East / Africa Asia / Australia / New Zealand B3. Projects click for list Project 001 Project 002 Project 003 Project 004 Project 005 Project 006 Project 007 Project 008 Project 009 Project 010 C. Date Form Opened Date range (if applicable) D. EMAIL ADDRESS OF PERSON WHO OPENED FORM E. STATUS OF FORM Open Completed F. ACTIVITY INFORMATION F1. Type of Interaction Conference / Event Business Association Meeting Possible Consortium or JV Current Consortium or JV Other F2. Description of meeting or interaction (or upload meeting notes / minutes here) Drop a file here or click to upload Choose File Maximum upload size: 2.1MB F3. Summary of what was discussed F4. Country click for country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte d'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Norway Northern Mariana Islands Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe F5. Name(s) of our Company people involved F6. Name(s) of people, title and companies involved - contact information is available (or upload business cards here) Drop a file here or click to upload Choose File Maximum upload size: 2.1MB G. COMPLETED AND CONFIRM AS ACCURATE click for virtual signature 1. Full Name and Title 2. Email Address (if different from person who opened form) 3: Date If you are human, leave this field blank. Submit
