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REPORT FORM

Please provide information as follows:

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Organization/Tier : SOCAR-KBR LLC

Location where Azerbaijan incident occurred: Hyatt Tower 3, 2nd floor, Izmir street 8 City: Baku

Zip/Postal Code: AZ1065

Country: Azerbaijan

Do you wish to remain ANONYMOUS for this report?

If you want SOCAR-KBR LLC to know your identity, please select the answer "no" from the above options.

Contact

8 Izmir Street, Hyatt Tower #3

Baku, Azerbaijan, AZ 1065

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Tel: +994(12)2102100

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info@socar-kbr.az

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