RESEARCH ADMINISTRATION AND COMPLIANCE OFFICE UNIVERSITY OF CALIFORNIA, BERKELEY PHS Financial Discl 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Investigator Information' section. Enter your name, department, email, and phone number. Select whether this is a new proposal.
3. In the 'Disclosure' section, provide details about any significant financial interests related to your institutional responsibilities. Check all applicable disclosure types and indicate if these interests relate to the PHS-funded research project.
4. For each financial interest, specify the entity name, income amount, and whether it is publicly or non-publicly traded. Indicate if you acquired this interest in the past 30 days.
5. Complete the 'Reimbursed or Sponsored Travel' section by listing any travel exceeding $5,000 per entity for both past and planned trips.
6. Finally, review the 'Acknowledgment and Certification' section. Sign and date the form to certify that all information provided is complete and accurate.

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