Code of Business Ethics and Conduct & Insider Trading
Statement and Questionnaire
(Prepare in duplicate, forwarding the original to Human Resources. Retain the copy for your personal files - attach extra
pages, as needed.)
1. I,
, hereby declare and certify that I have read the Code of Business Ethics
and Conduct and the Insider Trading/Securities Trading Policies of Hawaiian Airlines and that I have abided by, and
will abide by, the Code and Insider Trading provisions during my employment with Hawaiian Airlines and further
state that I realize failure to observe and comply with the Code and Insider Trading provisions shall be basis for my
dismissal.
2. I declare that my family and/or I do not own in excess of one percent (1%) of the stock of any business enterprise,
company or partnership whose shares are listed on public security exchanges/markets or regularly traded over the counter
which does business or competes with Hawaiian Airlines except as listed below (if none, check none).
Stock
Date of Purchase
None
3. I declare that my family and/or I directly or indirectly do not own any interest (other than listed or publicly traded securities)
in any entity which does business or competes with Hawaiian Airlines except as listed below (if none, check none).
Organization
Ownership Interest
Relationship
Date of Purchase
Name of Competitor/Business Partner
None
4. I am reporting the following additional transactions and/or arrangements in accordance with the requirements of the Code
of Business Ethics and Conduct (if none, check none).
None
5. Please check applicable statement.
a. I represent and warrant to the Company that I am
not in the possession of any material, non-public
information, whether positive or negative, that if publicly
disclosed might have an effect on the market for
Company Securities generally or that an investor might
consider important in deciding whether to buy, sell or
hold Company Securities.
b. I represent and warrant to the Company that due to my
position and area of authority in the Company, I am (or may be
in the future) in the possession of material, non-public
information, either positive or negative (i.e. monthly financial
results, forecasts, etc.), that if publicly disclosed might have an
effect on the market for Company Securities generally or that an
investor might consider important in deciding whether to buy,
sell or hold Company Securities. I acknowledge that I must
receive advanced written approval before effecting any
transaction in Company Securities.
(over)
)
6. I will immediately report to my supervisor any changes or additions to the information I have provided on this
form, including any future relationships, interests, transactions and arrangements of the kinds listed above and in
the Code, as they arise during the course of my employment with Hawaiian Airlines.
7. I understand and agree that it is my responsibility to fully and accurately provide the information required by this form,
including reporting any change in the information provided. Failure to provide complete and accurate information may result
in disciplinary action up to and including termination.
Print Name
Job Title
Signature
Date