MacroHI Co., Ltd. - Stakeholder Grievance Form

I

Basic Information and Confidentiality Request of the complainant

1. Your Name

Explanation: If you wish to remain anonymous, this field can be left blank.

2. Your Stakeholder Status

Employee Supplier Agency Customer Investor General Public Government Others

3. Your contact information*

Please provide your email address or phone number. If you do, the management unit can update you on the progress of your application, the investigation results, or request supplementary supporting information.

4. Agent's Declaration (if applicable)

Note: If you are filing this complaint on behalf of another directly affected party, please state your relationship with that party here and provide supporting authorization documents later.

5. Identity Confidentiality Preference*

[Strictly Confidential]: I request that the management maintain the utmost confidentiality regarding my identity. No personally identifiable information shall be disclosed to any third party (including the respondent and their supervisor) without my express knowledge and consent. [Confidentiality Waived]: The management is permitted to disclose my identity within a compliant and reasonable scope, if deemed necessary for the investigation. Other:

II

Details of the Appeal Case

1. The respondent*

Note: Please specify the target, department, or partner company name for this appeal.

2. Time and place of the incident*

3. Detailed Statement of the Event (Summary of key facts and timeline)*

Instructions: Please write down the key facts clearly and concisely, including the ins and outs of the event and the specific actions involved, so that the management unit can quickly and preliminarily identify the case and accept it.

4. Upload relevant supporting documents

Note: We welcome the uploading of any communication records, photos, documents, or reasonable clues that can corroborate the above facts. This will greatly expedite the internal processing and review process.

Add Files or drag & drop

Up to 10 files, max 2 MB each

III

Prior History and Expectations

1. Has this issue been raised with other channels within the company before?

Yes No, it's the first time.

2. Following on from the above, please explain the form of your previous feedback and the company's response at that time:

Note: For example, if you verbally raised this issue with your direct supervisor, and the supervisor's response at the time was...

3. Your expected solution

IV

Prevention of Conflicts of Interest and Submission of Declarations

[MacroHI Stakeholder Conflict of Interest Prevention Commitment] :

Upon receiving this form, our company will assign an independent management unit with no conflict of interest to review the case. If the person you are complaining against involves personnel of the receiving unit, that person will be strictly subject to the principle of recusal and will not be allowed to access, participate in, or interfere with any investigation or decision-making process of the case, ensuring the impartiality of the investigation.

V

Declaration of Good Faith Submission

[Declaration of Good Faith Submission] * I certify that the information filled out above and the supporting materials provided are factual and submitted in good faith.