Indicates required field Step 1: Contact Information Would you like your identity, or any information communicated as part of the Complaint to be kept confidential? Check which apply – see the IAM Policy and Procedures for more information regarding retaliation and confidentiality. Yes No Full legal name(s) of the person(s) or organization(s) filing the Complaint and contact information (address, telephone number, email address): Is this a Representative making a complaint on behalf of a Complainant(s)? Yes No Please provide proof of authorization and full legal name(s) and contact information for the Complainant(s) attached to this form. One file only.100 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. Step 2: Required Information Regarding the Complaint Detailed description of the alleged Harm Please provide a detailed description of the alleged Harm, whether actual or potential, caused to yourself, or if you are a Representative, to the Complainant(s), and how you allege FinDev Canada may have contributed to that Harm. The FinDev Canada IAM Policy and Procedures defines Harm as “any material adverse environmental and/or social effect on people or the environment resulting directly or indirectly from a Transaction. Harm may be actual or reasonably likely to occur in the future.” Please provide as much detail as possible including when you became aware of this Harm. Additional documents may be included if more space is needed. Additional documents Unlimited number of files can be uploaded to this field.100 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. Additional images Unlimited number of files can be uploaded to this field.100 MB limit.Allowed types: gif, jpg, png, svg. If known, what is the name of the FinDev Canada Transaction and location? A list of FinDev Canada Transactions are available on the page under Disclosure of Transactions. Have you previously reported your concerns to FinDev Canada or any other organization? If yes, please provide details about these communications and why you are not satisfied with the response, if any. If no, please explain why such efforts were not undertaken. Step 3: Additional Information What outcomes are you looking to achieve through the FinDev Canada IAM Process? What IAM function are you interested in pursuing? Dispute Resolution: FinDev Canada IAM can help resolve a Complaint through a neutral, collaborative, approach with a view to agreeing on actions to mitigate potential or actual Harm. Compliance Review: FinDev Canada IAM will determine whether FinDev Canada has complied with the provisions of its Environmental and Social Policy and the Transparency & Disclosure Policy. Additional details regarding these functions are provided in the IAM Policy and Procedures. What would be your preference (check which apply)? I am interested in the Dispute Resolution option I am interested in the Compliance Review option I am interested in both options Step 4: Attestation and Disclosure FinDev Canada IAM is under no obligation to consider a frivolous, fraudulent or malicious Complaint nor any Complaint arising out of or connected to a conflict of interest motivated by an intention to gain competitive advantage. You are encouraged to attach additional documentation supporting the nature of your Complaint, as applicable. By checking this box and submitting this Complaint Form you attest, to the best of your knowledge, that (i) this Complaint is not frivolous, fraudulent or malicious in nature, and (ii) that a conflict of interest, motivated by an intention to gain competitive advantage, does not exist. In connection with the foregoing, you further acknowledge and understand that FinDev Canada IAM may contact you to gather more information about the nature of the Complaint before determining whether FinDev Canada IAM may move forward with responding to the Complaint.