Simplified Conflict Minerals Reporting Template (CMRT)
Section 1: Company Information
- Company Name: ____________________________
- Contact Name: ____________________________
- Contact Email: ____________________________
- Scope of Report: ____________________________ (e.g., specific products or supplier categories)
Section 2: Conflict Minerals Policy
Our company is committed to sourcing materials responsibly and complying with applicable regulations regarding conflict minerals. We request that suppliers ensure their products are conflict-free and provide the required sourcing information.
Section 3: Supplier Declaration
- Do the products supplied contain any of the following minerals: tin, tantalum, tungsten, or gold (3TG)?
- If yes, please provide the following information:
- Name of Smelter/Refiner: ____________________________
- Country of Smelter/Refiner: ____________________________
Section 4: Geographic Sourcing
- Are materials sourced from the Democratic Republic of Congo (DRC) or adjoining regions?
- If yes, have you conducted due diligence to ensure responsible sourcing?
Section 5: Certification
I certify that the information provided is accurate to the best of my knowledge.
- Name: ____________________________
- Title: ____________________________
- Date: ____________________________