AGENSI PEKERJAAN MATCHLINK SDN BHD

(402027-U JTR1265)

ANNEXURE 3
CONFLICT OF INTEREST DECLARATION FORM
Employee Particulars
Name/Designation
NRIC/Foreign Identification No.
Group/Division/Dept:
CONFLICT OF INTEREST
(a) Personal Conflicts of Interest
(i) Do you have any relative working in Sudong or any
SingTel Group Company?

No
Yes (please provide details below)

Name of Relative:
Designation:
Job Function:
(e.g. Sales/Marketing/Finance)
Name of Reporting Officer:
Nature of Relationship

Spouse

Parent

In-law

Sibling

Nephew

Niece

Aunt

Uncle

Grandparent

Do any of these relationships give rise to any potential

Conflict of Interest?

Others (please state) :

No
Yes (please provide details below)

(ii) Do you have any relatives working in competitor

companies

No
Yes (please provide details below)

Name of Relative:
Name of competitor company:
Designation:
Job Function:
(e.g. Sales/Marketing/Finance)
Nature of Relationship:

Spouse

Parent

In-law

Sibling

Nephew

Niece

Aunt

Uncle

Grandparent

Others (please state) :

Do any of these relationships give rise to any potential
Conflict of Interest?

No
Yes (please provide details below)

W-09-01, Level 9, Amcorp Business Suite, Menara Melawangi, No. 18, Jalan Persiaran Barat,
46050 Petaling Jaya, Selangor Darul Ehsan.
Tel: 03-7955 2988/012-219 3133 Fax: 03-7956 7688
E-mail: matlink@po.jaring.my, apmatchlink@gmail.com
Website: www.matchlink.com.my
1

(iii) Do you have any relatives who are vendors, suppliers

or business partners of Sudong or any SingTel Group
Company?

No
Yes (please provide details below)

Name of Relative:
Name of vendor/supplier/business partner:
Designation:
Job Function:
(e.g. Sales/Marketing/Finance)
Nature of Relationship:

Spouse

Parent

In-law

Sibling

Nephew

Niece

Aunt

Uncle

Grandparent

Others (please state) :

Do any of these relationships give rise to any potential
Conflict of Interest?

No
Yes (please provide details below)

(iv) Do you have any relatives who are working with

Sudong or any SingTel Group Company vendors,
suppliers or business partners?

No
Yes (please provide details below)

Name of Relative:
Name of vendor/supplier/business partner:
Designation:
Job Function:
(e.g. Sales/Marketing/Finance)
Nature of Relationship:

Spouse

Parent

In-law

Sibling

Nephew

Niece

Aunt

Uncle

Grandparent

Others (please state) :

Do any of these relationships give rise to any potential
Conflict of Interest?

No
Yes (please provide details below)

(b) Financial or Business Conflicts of Interest

Do you have any direct or indirect financial or business
interests including personal investments in the business

No
Yes (please provide details below)

W-09-01, Level 9, Amcorp Business Suite, Menara Melawangi, No. 18, Jalan Persiaran Barat,
46050 Petaling Jaya, Selangor Darul Ehsan.
Tel: 03-7955 2988/012-219 3133 Fax: 03-7956 7688
E-mail: matlink@po.jaring.my, apmatchlink@gmail.com
Website: www.matchlink.com.my
2

of a customer, supplier, or business introduced by or

supplier, or anyone else with whom you are engaged in
a business relationship on behalf of Sudong or any
SingTel Group Company, which might or might appear
to, create a Conflict of Interest?
(c) Outside Employment/Business
Are you engaged in any outside employment/business?

No
Yes (please provide details below)

Date of Appointment:
Designation Held:
Name & Address of Company:
Time devoted to the outside employment/business per
week:
Fees/Remuneration:
Is there any Conflict of Interest arising by reason of the
above mentioned outside employment/business?

No
Yes (please provide details below)

No

Has written approval been granted by your VP, or higher

authority. As appropriate?

Yes(please provide details below)

(d) External Appointments/Directorship

Do you hold any external appointment/directorship?

No
Yes (please provide details below)

Date of Appointment:
Designation Held:
Name & Address of Company:
Time devoted to the appointment per week:
Fees/ Remuneration:
Is there any Conflict of Interest arising by reason of the
above mentioned external appointment/directorship?

No
Yes (please provide details below)

Has written approval been granted by your VP, or higher

authority, as appropriate?

No
Yes(please provide details below)

(e) Financial Embarrassment

W-09-01, Level 9, Amcorp Business Suite, Menara Melawangi, No. 18, Jalan Persiaran Barat,
46050 Petaling Jaya, Selangor Darul Ehsan.
Tel: 03-7955 2988/012-219 3133 Fax: 03-7956 7688
E-mail: matlink@po.jaring.my, apmatchlink@gmail.com
Website: www.matchlink.com.my
3

Are you subject to any financial embarrassment including

having been served bankruptcy proceedings or
declared a bankrupt?

No
Yes (please provide details below)

Declaration by Staff
I hereby declare that I have read the Conflict of Interest clause in the Code of Conduct and I understand the
contents thereof and consequences arising from a breach of the same.
I understand that I have to carry out my duties and responsibilities to the highest standards of personal and
corporate integrity when dealing with Sudong, its competitors, customers, suppliers, other employees and the
community.
I hereby declare that the information provided by me is complete and true.

Employees Signature

Date

W-09-01, Level 9, Amcorp Business Suite, Menara Melawangi, No. 18, Jalan Persiaran Barat,
46050 Petaling Jaya, Selangor Darul Ehsan.
Tel: 03-7955 2988/012-219 3133 Fax: 03-7956 7688
E-mail: matlink@po.jaring.my, apmatchlink@gmail.com
Website: www.matchlink.com.my
4