IRMA Stakeholder Feedback Form

*Name

Location

*Email

Telephone

*Name of mine you are providing feedback for:

*RELATIONSHIP WITH THE MINE: Community member, including any resettled/relocated groups Education or academia Indigenous or traditional authority representative Media Mine employee Mine contractor or supplier Non-governmental organisation (NGO) Labour union Local group, including social/community development, business, and industry sector groups Service provider, including healthcare, police, security and emergency services Other interested party – please provide more detail:

Other interested party

*PLEASE TELL US ABOUT YOUR EXPERIENCE WITH THE MINE, INCLUDING ANYTHING RELATED TO WHAT INFORMATION YOU RECEIVE FROM THE MINE, AND THE IMPACT OF THE MINING OPERATION ON THE LOCAL COMMUNITY, HEALTH & SAFETY OF WORKERS, AND THE ENVIRONMENT:

Would you like to participate in an interview with the ERM CVS audit team during our next on-site assessment?

PREFERRED METHOD OF INTERVIEW: Virtual interview In-person interview

*CAN THE FEEDBACK YOU PROVIDED BE SHARED PUBLICLY AS PART OF THE MINE AUDIT REPORT?

Fields marked with an asterisk (*) are mandatory.

*Consent I would like ERM CVS to keep me updated on future news and understand that the information provided by me is subject to ERM's Privacy Statement.