Government Official Notification Form

If you are any of the following type of government official, you must notify the Brink’s Ethics & Compliance Group by completing this form.

Definition of Government Official:

an elected official of any kind (current or in the last 5 years)
a government official of any kind for an entity that is a customer of Brink’s or an agency who has direct regulatory oversight (such as licensing or other authority) over Brink’s; or
a close relative (parent, child, sibling) of someone that meets the above criteria.

1. Are you reporting a government official relationship for yourself or another employee? *This question is required.

Explain how the Government Official is related to you. *This question is required.

2. Have you previously disclosed this to Brink’s? *This question is required.

3. Provide the name of person who is the Government Official. *This question is required.

4. Provide the title of the person that is a Government Official. *This question is required.

5. Provide the government entity for which the Government Official works. *This question is required.

6. Select the primary government category of the government entity (definitions are above). *This question is required.

Describe how the government entity represented has the ability to influence Brink’s business. *This question is required.

8. Describe the role of the person who is the Government Official. *This question is required.

Describe how the role of this Government Official can influence Brink’s business. *This question is required.

10. In what country does the Government Official reside? *This question is required.

11. Provide any other details to explain the Government Official relationship.

12. Provide your name. *This question is required.

13. Provide your email address. *This question is required.

14. Provide the email address of your supervisor. *This question is required.

15. Date *This question is required. This question requires a valid date format of MM/DD/YYYY.

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