ESG Diligence Questionnaire

Dummy form for testing the EA EasyAutofill browser extension.

Company information

What is the legal name of your organisation?

Provide the registered name as it appears on incorporation documents.

Company website

Date of incorporation

How many full-time employees does the company have?

Headquarters country

Governance

Does the company have a published code of conduct?

Yes No In progress

Which of the following policies are formally documented? (select all that apply)

Anti-bribery and corruption Whistleblower protection Data privacy Modern slavery Conflict of interest

Describe the composition of your board of directors.

Include the total number of directors, independent directors, and gender diversity.

Environmental impact

Does the company measure its Scope 1 and Scope 2 greenhouse gas emissions?

Yes, reported annually Partial — some categories only No

Describe your emissions reduction target, if any.

What percentage of your electricity comes from renewable sources?

Social and workforce

Does the company conduct annual employee engagement surveys?

Yes No

Describe your approach to diversity, equity and inclusion.

Most recent gender pay gap (median, %)

Contact

Primary contact name

Primary contact email

Additional notes

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