Grievance Submission Form

Parent Group Name

Supplier Type * Select Supplier Type Refinery Mill Plantation

Supplier Name * Select Supplier Name

Type of Grievance * Select Type of Grievance Environmental Social Environmental & Social Others Note: If the category is not found, please choose "Others" and specify.

Grievance Sub-Category * Child labour Community conflict Habitat destruction Natural ecosystem depletion FPIC Working condition Community land conflict Community land grabbing Unsafe working conditions Violence Harassment Involuntary community displacement Deforestation Fire Illegal oil palm development Illegal conversion to oil palm plantation Peat development Exploitation Forced labour Plasma obligations Human rights of indigenous community violation Illegal oil palm management Intimidation Corruption Illegal sourcing of FFB Peat clearance Peat fire River pollution Slave labour Illegal wildlife posession Illegal FFB harvest Illegal oil palm plantation Peatland Development Note: If the category is not found, please add to list

Hectare (Ha) *

Latitude

Longitude

Province

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