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FCPA Questionnaire

The FCPA Questionnaire is designed to ensure Chevron's compliance with relevant legislation before entering into business or employment relationships. It includes five questions regarding current or former associations with government officials or state-owned enterprises, with the acknowledgment that answering 'Yes' may lead to further screening but does not disqualify a candidate. The document also defines a 'government official' broadly and requires consent for the collection and use of the provided information.

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49 views1 page

FCPA Questionnaire

The FCPA Questionnaire is designed to ensure Chevron's compliance with relevant legislation before entering into business or employment relationships. It includes five questions regarding current or former associations with government officials or state-owned enterprises, with the acknowledgment that answering 'Yes' may lead to further screening but does not disqualify a candidate. The document also defines a 'government official' broadly and requires consent for the collection and use of the provided information.

Uploaded by

sara khan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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FCPA Questionnaire

The following 5 questions are for the purpose of ensuring Chevron’s compliance with all relevant legislation.
Chevron requires completion of these 5 questions prior to entering into a business or employment relationship
with an individual. Answering Yes to any of these questions will NOT disqualify you from consideration, however, it
may lead to additional screening of the potential business or employment relationship for compliance and Chevron
may need to contact you for additional information regarding the current or former government association.

By answering these questions, I consent to the collection and use of the information for the purposes of ensuring
compliance with all relevant legislation and acknowledge that I will be forthright in my responses.

Please note the following definition: A “government official” is defined broadly and includes any officer, employee
or other person acting in an official capacity for a government, or any business that is owned or controlled by that
government. Examples of the term “government official” include elected officials, party officials, candidates for
elected office; public servants, employees of state-owned enterprises (e.g. CNPC, Petrobras, PDVSA, Sonangol) and
officers, employees or other personnel acting in an official capacity or a public international organization such as
the United Nations, World Bank, and the International Committee of the Red Cross.

Question Answer
Are you a current or former government  Yes
employee?  No
Are you a current or former employee of a  Yes
company owned by any government(s)?  No
Are you a close relative (e.g. parent, child,  Yes
spouse, sibling or nephew/niece) of a current  No
or former government employee(s)?
Are you a close relative (e.g. parent, child,  Yes
spouse, sibling or nephew/niece) of a current  No
or former employee of a company owned by a
government(s)?
If you answered “YES” to any of the questions
above please provide the following:
− Last Name and First Name of the N/A
government official(s):
− Title or Position of the government
official(s):
− General Description of the
government official’s responsibilities:
− Organization: Indicate the name(s) of
the government
organization(s)/agency(ies) that the
individual(s) has worked for.
− Country: Where the government
official(s) acted in an official capacity.
If you answered “NO” to all of the above
questions, please enter “N/A”.

Name Date

Amber Alam. 03-26-2024

Sensitivity: Internal / Non-Personal Data

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