GameStop 2010 Annual Report Download - page 132

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Appendix A
ANNUAL STANDARDS, ETHICS AND CONDUCT POLICY ACKNOWLEDGEMENT FORM
Name:
Office/Department:
Date:
1. Instructions
Associates are required to file a Standards, Ethics and Conduct Policy Acknowledgment and Conflict of Interest Disclosure Form annually and when
situations arise that create an actual, potential, or apparent conflict of interest. Officers of GameStop and any Associates who purchase goods or services for
GameStop or who enter into and administer contracts on behalf of GameStop must complete and file this form annually. Associates who are responsible for
sensitive or confidential information may also be required to complete this form annually.
Complete the form and if you have a "Yes" response to either Item 2, 3 or 4 or a response other then "None" or "N/A" to Item 5, forward it in a
sealed envelope marked "PERSONAL AND CONFIDENTIAL" to your department head. The department head reviews the disclosures and discusses
with you any steps necessary to resolve conflicts. The department head must certify either that:
• The conflict disclosed by the Associate is not one that is prohibited under GameStop's Conflict of Interest Policy or other policies; or
• The Associate has taken appropriate steps to resolve the conflict.
2. Offices and Positions
Are you, your spouse, dependent or other household member an officer, director, trustee, partner (general or limited), associate, or regularly retained agent of
any organization with which:
a. GameStop has had business dealings during the past year; or
b. GameStop might have business dealings in the next year?
YES NO
If "YES," please provide the following information:
Name (You or
Family or Household Organization's
Organization Position Member) Business
3. Ownership Interests
Do you, your spouse, dependent or other household member have the actual or beneficial ownership of stock, equity, debt, or any other financial interest in
any organization with which:
a. GameStop has had business dealings during the past year; or
b. GameStop might have business dealings in the next year?
YES NO
If "YES," please provide the following information:
Name (You or
Investment Family or Household Organization's
Organization Description Member) Business
11