AFFIDAVIT

I, __________, (nationality), of legal age, with address at_________________________, after

having been sworn in accordance with law, hereby depose and state that:

1. I am the _________________________________________________ (add details of actual/

potential/perceived conflict situation).

2. I confirm that the abovementioned (position/activity) outside Accenture, Inc. (“Accenture”) will
not affect my efficiency in the performance of the duties, roles and responsibilities that I will be
taking on when I join Accenture.

3. Moreover, I acknowledge that I do not have a personal conflict of interest situation where my
own personal interests (or those of an immediate family member or close relative) affects my
ability to act in Accenture’s best interests, or interferes with my personal activity and obligations
to Accenture.

4. I understand that a personal conflict may be an actual conflict, a potential conflict or a perceived
conflict, and it is my responsibility to identify them, because I acknowledge that a personal
conflict, by its very nature, is personal.

5. I understand that in case of a personal conflict situation, Accenture expects me to exercise good
judgment and follow Accenture’s requirements, which include but which are not limited to:

• Identifying the personal conflicts and promptly advising Accenture;

• Obtaining any required approvals and following any restrictions. If Accenture requires
me to obtain any additional approvals or to take steps to avoid the personal conflict, I shall
comply with those requirements and ask for these approvals or steps in writing; and

• When I am not sure if a personal conflict has arisen, or may arise, or what the approval
process is, I will reach out to my assigned People Advisor or the Ethics Group to determine if a
personal conflict exists.

6. I undertake to minimize the consequences of a personal conflict, by working with Accenture to

address any personal conflict situation that has arisen and will follow all steps required by
Accenture’s policies relating to personal conflicts.

7. I acknowledge that Accenture takes policy violations very seriously and depending on the facts
and circumstances involved, issues may be dealt with as a disciplinary matter and may lead to
disciplinary action (up to, and including, termination of employment).

8. I acknowledge that, subject to any applicable legal requirements, it is in Accenture’s discretion

as to how to respond to any violation of policies related to personal conflicts.

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9. I authorize Accenture to look further into the circumstances where personal conflict may arise in
my activities and roles outside of Accenture.

10. I have executed this Affidavit to attest to the truthfulness of all the forgoing facts and
circumstances.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _________________ at

___________ City.

_____________

Affiant

SUBSCRIBED AND SWORN to before me this ___________ at ____________, affiant exhibiting to me

his/her ________ ________with no. ___________ issued in __________ on ___________.

Doc. No. ____;

Page No. ____;

Book No. ____;

Series of 2016.