The Conflict Of Interest Form Template UK is provided in multiple formats, including PDF, Word, and Google Docs, featuring customizable and printable samples to meet your needs.
Conflict Of Interest Form Template UK Editable – PrintableSample
Conflict Of Interest Form Template UK 1. Individual Information 2. Declaration of Interests 3. Relationship to Any Third Parties 4. Previous Conflicts of Interest 5. Steps Taken to Manage Conflicts 6. Acknowledgement of Responsibilities 7. Reporting Mechanism 8. Additional Comments 9. Declaration and Signatures
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WORD
Examples
[Name of the Individual]
[Applicant’s ID]
[Applicant’s Address]
[Applicant’s Phone]
[Applicant’s Email]
[Title of Position/Role within the Organization]
This form serves to disclose any potential conflicts of interest that may arise from your position. Please describe any financial, personal, or professional relationships that may present a conflict:
[Explain the potential conflict, including names of involved parties and the nature of the relationship. Be as detailed as possible.]
[Describe any measures you have taken to mitigate this potential conflict of interest, such as recusal from certain decisions or discussions.]
I declare that the information provided in this form is accurate to the best of my knowledge. I understand that failure to disclose relevant information may lead to disciplinary actions.
[Signature of the Individual]
[Name of the Individual]
[Name of the Individual]
[Individual’s ID]
[Individual’s Address]
[Individual’s Phone]
[Individual’s Email]
[Department/Team Name]
This form is intended to disclose relationships that may lead to a conflict of interest. Please outline any relevant relationships with external parties or other staff members that could influence your impartiality:
[Provide a thorough description of any relevant relationships that might create a conflict, including names of parties involved and the nature of the relationship.]
[Outline any potential solutions or actions you have taken to prevent this conflict from affecting your decision-making process.]
I confirm that the details provided in this disclosure are true and complete. I recognize that any misleading information could result in serious consequences.
[Signature of the Individual]
[Name of the Individual]
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