Pricing Errors, Breaches and Errors Reporting Form

Report Details

Client Name: *

Cell/Sub-Fund: *

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Nature of Report *

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If Other, please detail:

Date of Occurence *

Date Identified by EPIC: *

How Identified: *

Matter Detail:

Initial Details

Initial Summary: (i.e. what should have happened but didn't?) GIVE ALL DETAIL, SUCH AS DEAL NUMBERS, VALUE DATES, TRADE DATES, VALUATION DATES APPLICABLE TO THE BREACH) *

What element of the procedure was not followed? *

Who is impacted? (e.g. name of shareholder or client etc) *

What was the effect of the breach / error / complaint / incident? *

Who was involved? (team and individual staff members involved, indicating whether preparer or 4-eyes checker etc) *

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Has the matter given rise to a complaints as well? *

Complaints

Name of Complaint: *

Capacity in which complaint is made: *

Team and or Member of Staff complaint about: *

Summary of Complaint: *

Pricing Error?

Percentage of Pricing Error

PE Threshold

Monetary Loss

Is it likely that this matter will result in monetary loss to: *

The client?

How

The investor?

How

EPIC?

How

Data Protection Breach

Does this matter include any loss or wrongful transmission of personal data to a third party? *

DP Breach Required? *

Sign off

Name of Person Reporting: *

Date: *

Name of Person Authorizing Report *