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Area—Please choose an option—Federal Territory of Kuala LumpurFederal Territory of LabuanFederal Territory of PutrajayaJohorKedahKelantanMalaccaNegeri SembilanPahangPerakPerlisPenangSabahSarawakSelangorTerengganu
Product To Trade-In—Please choose an option—TITANWARRIORXCELIRIS TOPVIVIDPRINCE TOPICONJAZZMARVELQUEEN STANDR ModelK ModelC ModelC+ ModelD ModelB Model Cordless
By submitting this application, you hereby agree and authorise CUCKOO International (MAL) Sdn Bhd and its subsidiaries for the collection, use, process and/or disclosure of your personal data for follow-up action regarding any request received in accordance with the Personal Data Protection Act 2010 and our Privacy Notice.
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Product—Please choose an option—TITANWARRIORKING TOP 2XCELVIVIDIRIS TOPPRINCE TOPICONQUEEN STANDMARVELR ModelK ModelC ModelD ModelB Model CordlessC+ ModelR06P10JHT10Q10CH10INDUCTWOINDUCTRIOKYNEDELL PREMIUM COOKWARE (2-PIECE PLUS)PRIME X3A-SERIES MATTRESS KINGA-SERIES MATTRESS QUEENA-SERIES MATTRESS SUPER SINGLEVITA-S INVERTERUNIQCUCKOO Bespoke Massage Chair
Topic—Please choose an option—GOOOD PlanProductWarrantyMarketingFeedbackOthers
While all reporting of improper conduct in good faith and not for malicious intent will be investigated, a Whistleblower is encouraged to identify himself/herself when reporting, for credibility purposes and to allow an avenue for CUCKOO to follow up to ascertain the facts or to obtain further information for investigation purposes. Please attach reliable evidence to substantiate your disclosure and assist in the investigation. You may use additional sheets for additional witnesses or supporting evidence if necessary.
Part A: Disclosure Details
Name of person(s) involved in the incident or issue.
If money is involved, please indicate the amount involved.
Do you suspect any other people that are involved? Please provide the details, if any.
Do you suspect that the management is involved? Please provide the details, if any.
Have you notified anyone? Please provide the details, if any.
Any witness? Please provide the name, department and other relevant details.
Date, Time and Location of the incident or issue?
How did you discover the incident or issue?
Please provide a description of the incident or issue.
Part B: Whistleblower Details
Are you an employee of CUCKOO?
Contact Number or Email Address (Mandatory)
Username or email address *
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