Get Financial Interests Disclosure Form - Lehigh University

Filling out the Financial Interests Disclosure Form is an essential process for investigators participating in PHS-funded research at Lehigh University. This guide will help you understand each section of the form and provide step-by-step instructions to ensure accurate and timely completion.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the Financial Interests Disclosure Form and open it in your preferred editing tool.
2. Begin by entering your name in the designated field at the top of the form.
3. Indicate the reporting period by checking the appropriate box for either 'for the year ____' or 'as an addendum to my most recent report'.
4. Review the instructions provided. Make sure to consider your activities within the preceding 12 months and note that 'your family' refers to your spouse, domestic partner, and dependent children.
5. Answer the compensation question by selecting 'yes' or 'no' regarding whether you or a family member received compensation exceeding $5,000 from an external entity related to your work at Lehigh.
6. Proceed to the travel expenses section and indicate whether you or your family have been reimbursed or had travel paid for by an entity related to your work.
7. Complete the questions regarding equity interests both in publicly-traded and non-publicly-traded entities by selecting 'yes' or 'no' as applicable.
8. Answer the role question to disclose if you or a family member serve as a director or key employee in a related external entity.
9. Indicate any rights or royalties related to intellectual property, ensuring you note any relevant exclusions as mentioned in the question.
10. If you answered 'yes' to any of the questions, attach a separate page detailing the necessary aspects of your disclosures, including the name of the entity and nature of the relationship.
11. Finally, sign and date the form, certifying that you have completed it to the best of your knowledge and agree to promptly revise it if any changes occur.
12. After completing the form, you can save your changes, download it, print a copy, or share it as needed.

Take the next step and complete your Financial Interests Disclosure Form online today.