Halstead & Roe
Compliance & Governance

Policy Acknowledgment

Compliance Record · Form GOV-2
Acknowledgment statement

I confirm that I have read, understood, and had the opportunity to ask questions about the policy named above, in the version and effective date recorded. I agree to comply with its requirements in the course of my work, and I understand that a violation may result in disciplinary action up to and including termination.

I have read this policy in full and I agree to comply with it.

Acknowledging employee

Signature

Employee signature
Date signed