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Community dialogue mechanism

RECEPTION FORM

1. PERSONAL INFORMATION

DO YOU WISH TO SUBMIT YOUR CASE WITH YOUR NAME OR WITHOUT YOUR NAME?
*If you selected the “anonymous” option, do not fill in the information in the box below.
WHICH OF THE FOLLOWING GROUPS DO YOU IDENTIFY WITH?
(Check one or more options, as applicable)

2. WHAT KIND OF MESSAGE DO YOU WANT TO SHARE?

Mark your choice with X, one option only:

TYPE OF MESSAGE

USE THE FOLLOWING QUESTIONS TO HELP EXPLAIN YOUR CASE

CONGRATULATIONS

Recognizes achievements
or positive actions.

1. What achievement or action would you like to acknowledge?
2. What is being done well, and is there anything else that should be considered?

REQUEST

A request for information, support, recommendations, or suggestions.

1. What would you like to know or request from Lundin Gold?

COMPLAINT OR CLAIM

A complaint expresses dissatisfaction
or annoyance.
A claim reports damage, harm, or a
possible breach of contract.

1.What happened?
2. Where did it happen? (location)
3. When did it happen? (date)
4. Who was involved (those affected, those responsible
witnesses, and anyone else)?
5. Did Lundin Gold violate any agreement, law, regulation
protocol, or formal commitment?
6. How would you like your case to be resolved?

3. DO YOU BELIEVE ANY HUMAN RIGHT HAS BEEN AFFECTED IN YOUR CASE?

If you answered “Yes,” mark one or more options with an X, if applicable:
Is your case related to any security or public order issue that threatens or puts at risk the community, Lundin Gold, your personal safety, or any other person?

4. ADDITIONAL INFORMATION

Do you have any documents, photos, videos, or other information to support your case?

Thank you for using Lundin Gold’s “Tu Voz Nos Encuentra” Community Dialogue Mechanism. Your case will be reviewed, and you will receive a response within the timeframes established by the Company.

Note: This form is a safe space for the community to submit congratulations, requests, and complaints or claims. The personal data provided in this form will be processed in accordance with the Organic Law on Personal Data Protection (hereinafter LOPDP), its regulations, and the Company’s Data Protection Policy. The data will not be used for purposes other than those specified.
The company guarantees the exercise of the rights set forth in the LOPDP. We are committed to the privacy and security of your personal data.