Get Employee Conflict Of Interest Disclosure Form Template

The Employee Conflict Of Interest Disclosure Form Template is designed to help employees disclose any potential conflicts that could interfere with their responsibilities at the University. This guide will provide you with step-by-step instructions on how to complete this important document online.

Follow the steps to complete the form accurately and efficiently.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred online editing tool.
2. Enter your personal information in the Employee Information section, including your name, campus and school/department, University ID number, position title, campus phone number, and email address.
3. In the Conflicts of Interest Disclosure section, start with Question 1. Disclose any relationships with vendors, contractors, or business entities. Provide their names, your relationship to them, and details about any immediate family members involved.
4. Proceed to Question 2 and indicate any economic interests you or your immediate family members have with relevant vendors or contractors. Include the name of the business entity, your relationship, the annual amount of profits or compensation, market value of equity, and any intellectual property rights.
5. For Question 3, if your disclosure pertains to a single transaction, list the specific vendor, contractor, or business entity involved, alongside your relationship and the details of the University purchase or contract.
6. In Question 4, describe any additional financial conflicts that may provide a personal financial benefit to you or an immediate family member in relation to University operations or business decisions.
7. Question 5 requires you to identify any other conflicts that may compromise your decision-making in your role at the University. Provide a thorough explanation.
8. If additional space is needed for your disclosures, attach extra pages as required and mention this in the relevant section of the form.
9. Complete the form by signing with your full legal name and entering the date in the designated signature section.
10. Ensure that your supervisor and unit head acknowledge your disclosures by providing their names, signatures, and dates as indicated on the form.
11. Finally, review your entries for accuracy, then save your changes, download the completed form, and print or share it as necessary.

Complete your documents online to ensure compliance and transparency in your professional responsibilities.