WeEWCREST LGO.HR.HRS.FOR.14.0203.1-0.Declaration of Interest Seto LMR Declaration of interest Name: _ Pay Number: Department: do solemnly and sincerely declare that; TICK THE BOX THAT APPLIES TO YOU (2) I HAVE NO personal, professional or business interests, partnerships, appointments, investments, property ownership or other activities which may conflict with the interest ‘of Newerest or the Newerest Group, or which may lead to a perception of contict. (_ b) THAVE personal, professional or business interests, partnership, appointments, investments, property ownership or other activities which may conflict with the interest ‘of Newcrest of the Newcrest Group, of which may lead to a perception of confit. (PLEASE COMPLETE THE REMAINDER OF THSS FORM) Companies in which | have an interest: My Interest (1) ] [___Nature of Business (2) T — | —— ‘Company I r t Signature: Date. Department Manager (4) Name: Signature: Date: Notes: (1) Eg; Part owner, director, clan company, owned by dosed relatives, ETC (2) Eg: Earthmoving, body tire, supply of goods, ETC (8) Eg: Employees awards work to companies inthis el, (4) Deparment Manager (not histher delegate) to sign Uneorirled Copy once ited | lave Date 27082011 Last prt 5087201 1 [Page sos Document Owner : Superintendent HR.