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Click ‘Get Form’ to open the Financial Disclosure and Conflict of Interest Statement in our editor.
Begin by entering your name and position held in Section I. This information is crucial for identifying your role within the university.
In Section II, provide details about your spouse, including their name, employer, and position. If self-employed, specify the nature of their occupation.
For each dependent child listed in Section III, include their name, employer details, and position held. Repeat this for up to three children as needed.
Section IV requires you to list any business entities where you or your family members hold a substantial interest. Be sure to indicate compensation received and the category of interest.
In Section V, document any nonprofit entities where you or your family members serve as officers or board members.
Section VI asks for any gifts exceeding $250 received by you or your family. List each donor and a brief description of the gift.
Complete Sections VII through XII by answering questions regarding business relationships with UT Austin, acknowledging compliance with policies, certifying the information provided, and obtaining necessary signatures.

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What is an example of a disclosure of conflict of interest statement?

The AEA policy requires one to state explicitly that she or he does not have a conflict of interest. A disclosure statement in such a case might read: The author declares that (s)he has no relevant or material financial interests that relate to the research described in this paper.

What is a conflict of interest disclosure?

A conflict of interest arises when personal interests or relationships may or do affect professional duties and cause potential bias in decision-making. Companies will want to be sure to identify, disclose, and manage these conflicts appropriately to preserve transparency, trust, and ethical standards.

What is a conflict of interest statement?

Example 1: If you have shares in a company that has a matter before the meeting, you are closely associated with that company. You therefore have an interest that must be disclosed. You could disclose the nature of your interest as I am closely associated with the company making the application.

What is an example of a disclosure of interest?

I hereby docHub that, to the best of my knowledge, neither I (including any member of my immediate family) nor any individual or entity with whom or wijt h which I have a docHub working relationship have (has) received something of value from a commercial party related directly or indirectly to the subject of

What is a conflict of interest disclosure statement?

Financial conflicts of interest occur when an individual or organization stands to benefit financially from decisions or actions taken in their professional capacity. This type of conflict can arise when a financial advisor receives kickbacks from institutions for recommending or selling certain financial products.