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{% extends "base_projects.html" %}
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{% block subtitle %}Conflict of Interest Policy - {% endblock %}
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{% block submenuselection %}Policies{% endblock %}
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{% block content %}
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<h1 id="software-freedom-conservancy-conflict-of-interest-policy">Software Freedom Conservancy Conflict of Interest Policy</h1>
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<h2 id="purpose">Purpose</h2>
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<p>The purpose of this conflict of interest policy (“Policy”) is to protect
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the Software Freedom Conservancy (“Conservancy”) and its Member Projects
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when Conservancy contemplates entering into a transaction or arrangement
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that might benefit the private interest of a Director, Officer or Staff
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Member of Conservancy or a member of a Project Leadership Committee
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(“PLC”), or might otherwise result in a possible excess benefit
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transaction. This Policy is intended to supplement but not replace any
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applicable state and federal laws governing conflict of interest
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applicable to nonprofit and charitable organizations.</p>
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<h2 id="conservancy-directors-officers-and-staff">Conservancy Directors, Officers and Staff</h2>
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<p>Directors, Officers and Staff Members of Conservancy (“Conservancy
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Persons”) each have a duty to protect Conservancy and its Member Projects
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from violating New York State and USA federal – and to avoid any appearance of
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impropriety. Conservancy Persons serve the public interest and are to have
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a clear understanding of Conservancy’s charitable mission. All decisions
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made by Conservancy Persons are to be made solely on the basis of a desire
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to promote the best interests of Conservancy and the public good.</p>
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<h3 id="defining-a-conflict-of-interest-for-a-conservancy-person">Defining a Conflict of Interest for a Conservancy Person</h3>
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<p>In general, Conservancy Persons should avoid making decisions on matters
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where their personal interests are at odds with the Conservancy’s
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interests. In particular, the following scenarios are to be identified as
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conflicts of interest:</p>
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<ul>
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<li>
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<p>A Conservancy Person (or their family member) is a party to a
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contract, or involved in a transaction with Conservancy for goods
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or services.</p>
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</li>
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<li>
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<p>A Conservancy Person (or their family member) is a director,
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officer, agent, partner, associate, employee, trustee, personal
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representative, receiver, guardian, custodian, legal representative or in
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some other way has a fiduciary duty to an entity involved in a transaction
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with Conservancy.</p>
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</li>
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<li>
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<p>A Conservancy Person (or their family member) is engaged in a substantial
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capacity or has a material financial interest in a for-profit enterprise
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that competes with Conservancy or a Conservancy Project.</p>
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</li>
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<li>
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<p>A Conservancy Person (or their family member) has a material
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financial interest in, or fiduciary duty to an entity Conservancy
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has engaged in a free software license compliance effort, enforcement
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effort, or related litigation on behalf of a Conservancy project.</p>
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</li>
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<li>
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<p>A Conservancy Person (or their family member) has a material
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financial interest in or fiduciary duty to the competitor of an entity
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Conservancy has engaged in a free software license compliance effort,
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enforcement effort, or related litigation on behalf of a Conservancy
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project.</p>
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</li>
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</ul>
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<p>Conservancy acknowledges that other situations may create the appearance
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of a conflict, or present a duality of interests. All such circumstances
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should be disclosed to the Board, as appropriate, and the Board shall make
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a decision as to what (if any) course of action Conservancy or relevant
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Conservancy Persons should take so that Conservancy’s best interests are
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not compromised by personal interests.</p>
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<h3 id="general-policies-for-conservancy-persons">General Policies for Conservancy Persons</h3>
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<ul>
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<li>
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<p><strong>No Personal Profit or Gain.</strong> No Conservancy Person (or family
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member) shall derive any personal profit or gain, directly or indirectly,
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by reason of their participation with Conservancy. Personal profit
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or gain does not include compensation approved by the Board for paid
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employees, or reimbursement of legitimate Conservancy expenses.</p>
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</li>
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<li>
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<p><strong>Disclosure and Abstention when Conflicted.</strong> Each Conservancy
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Person shall disclose to Conservancy’s Board any conflict of interest
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which he or she may have in any matter pending before Conservancy
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and shall refrain from participation in any decision on such matter.</p>
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</li>
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<li>
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<p><strong>Conservancy Conflict Disclosure Form.</strong> Every one year, each
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Conservancy Person shall complete a Conservancy Conflict Disclosure
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form attached as Exhibit A and submit it to the Board</p>
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</li>
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</ul>
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<h3 id="conflict-resolution-procedures-for-conservancy-persons">Conflict Resolution Procedures for Conservancy Persons</h3>
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<ul>
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<li>
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<p><strong>Disclosure of Conflict When Present.</strong> Prior to any Board or
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Board Committee action on a matter or transaction involving a conflict
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of interest, a Conservancy Person having a conflict of interest and
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who is in attendance at the meeting shall disclose all facts material
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to the conflict. Such disclosure shall be reflected in the minutes
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of the meeting. If board members are aware that Staff or other volunteers
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have a conflict of interest, relevant facts should be disclosed by
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the board member or by the interested person him/herself if invited
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to the Board meeting as a guest for purposes of disclosure.</p>
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</li>
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<li>
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<p><strong>Disclosure of Conflict When Absent.</strong> A Conservancy Person
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who plans not to attend a meeting at which he or she has reason to
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believe that the Board or Board Committee will act on a matter in
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which he or she is conflicted shall disclose to the Chair of the meeting
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all facts material to the conflict of interest. The Chairperson shall
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report the disclosure at the meeting and the disclosure shall be reflected
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in the minutes of the meeting.</p>
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</li>
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<li>
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<p><strong>Participation in Discussions and Votes Regarding Conflicted Matter.</strong>
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On a matter in which a Conservancy Person has a conflict of interest, the
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conflicted Conservancy Person must abstain from, and must not hear nor
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read the pre-vote discussions of the matter by the Board or Board
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Committee, except to disclose material facts and to respond to
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questions. The conflicted Conservancy Person shall not attempt to exert
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their personal influence with respect to the matter, either at or
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outside the meeting. The Conflicted Person may read minutes and/or
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logs of the matter’s discussion after voting is complete.</p>
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</li>
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<li>
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<p><strong>Participation in Votes Regarding Conflicted Matter.</strong> A conflicted
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Conservancy Person may not vote on the Board action with which he
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or she has a conflict of interest, and shall not be present in the
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meeting room (or on the conference call) when the vote is taken. His
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or her ineligibility to vote shall be reflected in the minutes of
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the meeting.</p>
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</li>
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<li>
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<p><strong>Conflicted Persons Cannot Establish Quorum.</strong> A conflicted
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Conservancy Person shall not be determining the presence of a quorum
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for purposes of a vote on the matter where he or she has a conflict
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of interest.</p>
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</li>
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<li>
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<p><strong>Managing an Officer’s Conflict of Interest.</strong> If a Conservancy
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Person is an Officer involved in a decision, matter or transaction
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in which he or she has a conflict of interest, he or she must immediately
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disclose all facts material to the conflict to the Chair of the Board
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(or the Chair’s designee). The Board must then approve any future
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decisions, negotiations, and/or other actions taken by the Officer
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regarding the conflicted matter, and include the person’s disclosure
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of the conflict and the Board’s subsequent actions in the minutes
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of the next meeting.</p>
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</li>
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<li>
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<p><strong>Managing a Staff Member’s Conflict of Interest.</strong> If a Conservancy
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Person is a Staff Member who has been assigned duties that involve
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a decision, matter or transaction in which he or she has a conflict
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of interest, he or she must immediately disclose all facts material
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to the conflict to the President (or the President’s designee). The
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President (or designee) must then approve any future decisions, negotiations,
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and/or other actions taken by the Staff Member regarding the conflicted
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matter, and file a written report acknowledging the potential conflict.</p>
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</li>
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<li>
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<p><strong>Confidentiality of Conflict Disclosures.</strong> Each Conservancy
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Person shall exercise care not to disclose confidential information
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acquired in connection with disclosures of conflicts of interest or
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potential conflicts, which might be adverse to Conservancy’s interests.</p>
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</li>
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</ul>
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<h2 id="project-leadership-committees">Project Leadership Committees</h2>
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<p>PLCs are comprised of volunteers, academics, and industry professionals
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that represent a Project’s community and make decisions about a Project’s
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technical direction (“PLC Persons”). Conservancy understands and
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expects that many PLC Persons exploit professional skills relating
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to their Project as individuals by providing developing, consulting,
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and/or training services. Nonetheless, each PLC Person has a duty
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to act in the best interests of their Project when making technical
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decisions about the Project.</p>
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<h3 id="defining-a-conflict-of-interest-for-a-plc-person">Defining a Conflict of Interest for a PLC Person</h3>
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<p>In general, PLC Persons should avoid making technical decisions on
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matters where their personal and/or professional interests are
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at odds with their Project’s interests. In particular, the following
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scenarios are to be identified as conflicts of interest:</p>
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<ul>
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<li>
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<p>A PLC Person (or their family member) is a party to a contract,
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or involved in a transaction with Conservancy for goods or services
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relating to their Project.</p>
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</li>
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<li>
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<p>A PLC Person (or their family member) is an employee, owner,
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or otherwise has a financial interest in an entity involved in a transaction
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with Conservancy relating to their Project.</p>
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</li>
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<li>
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<p>A PLC Person (or their family member) is a director, officer,
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agent, partner, associate, trustee, receiver, guardian, personal representative,
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custodian, legal representative or in some way has a fiduciary duty
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to an entity involved in a transaction with Conservancy relating to
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their Project.</p>
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</li>
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<li>
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<p>A PLC Person (or their family member) is engaged in a substantial capacity
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or has a material financial interest in a for-profit enterprise that
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competes with their Project.</p>
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</li>
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<li>
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<p>A PLC Person (or their family member) is the owner of copyrights
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that are the subject of a Conservancy-led compliance effort, enforcement
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effort, or related litigation – and the PLC Person (or a family member)
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has a material financial interest in or fiduciary duty to an entity
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adverse to this effort.</p>
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</li>
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</ul>
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<p>Conservancy further notes that a scenario may arise where a PLC Person
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(or their family member) works for, owns, or otherwise has a
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financial interest in an entity that competes with a second entity
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involved in a transaction with Conservancy regarding the Project in
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question. This may or may not result in a conflict of interest, depending
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on the specific facts. Should this scenario arise, Conservancy requests
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that the circumstances be disclosed to Conservancy’s Executive Director
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and to the PLC.</p>
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<p>Conservancy acknowledges that other situations may create the appearance
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of a conflict, or present a duality of interests. All such circumstances
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should be disclosed to Conservancy’s Executive Director and to the
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PLC, as appropriate, and the PLC shall make a decision as to what
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(if any) course of action the PLC or relevant PLC Persons should take
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so that the Project’s best interests are not compromised by personal
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interests.</p>
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<h3 id="general-policies-for-plc-persons">General Policies for PLC Persons</h3>
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<ul>
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<li>
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<p><strong>No Compensation for PLC Persons.</strong> No PLC Person shall receive any
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salary or other substantial benefit from Conservancy as compensation for his
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or her duties as a PLC Person. Compensation does not include reimbursement
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of legitimate Project expenses.</p>
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</li>
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<li>
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<p><strong>Disclosure and Abstention when Conflicted.</strong> Each PLC Person
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shall disclose to their PLC and to Conservancy’s Executive Director
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any conflict of interest which he or she may have in any matter pending
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before the PLC and shall refrain from participation in any decision
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on such matter.</p>
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</li>
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<li>
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<p><strong>Multiple Employees from the same Employer on a PLC.</strong> Conservancy
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discourages the practice of having multiple employees of the same
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employer serve on the same PLC. This practice increases the impact
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of any prospective conflict of interest with the employer on the PLC,
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and PLCs will have to exercise greater care to avoid the influence
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of the employer’s interests. If this situation is unavoidable, PLCs
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are encouraged to err on the side of caution in identifying all potential
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conflicts of interest relating to the employer.</p>
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</li>
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<li>
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<p><strong>Conservancy is Final Arbiter.</strong> Each PLC Person acknowledges
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that Conservancy is the final arbiter of any issue relating to potential
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conflict.</p>
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</li>
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<li>
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<p><strong>Project Conflict Disclosure Form.</strong> Each PLC Person shall complete
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a Project Conflict Disclosure form attached as Exhibit B and
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submit it to the PLC and to Conservancy’s Executive Director on an
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annual basis.</p>
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</li>
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</ul>
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<h3 id="conflict-resolution-procedures-for-plc-persons">Conflict Resolution Procedures for PLC Persons</h3>
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<ul>
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<li>
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<p><strong>Disclosure of Conflict When Present.</strong> Prior to any PLC or
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PLC sub-committee action on a matter or transaction involving a conflict
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of interest, a PLC Person having a conflict of interest and who is
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in attendance at the meeting shall disclose all facts material to
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the conflict. Such disclosure shall be reflected in the minutes of
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the meeting.</p>
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</li>
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<li>
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<p><strong>Disclosure of Conflict When Absent.</strong> A PLC Person who plans
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not to attend a meeting at which he or she has reason to believe that
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the PLC or PLC sub-committee will act on a matter in which he or she
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is conflicted shall disclose to the Chair of the meeting all facts
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material to the conflict of interest. The Chair shall report the disclosure
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at the meeting and the disclosure shall be reflected in the minutes
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of the meeting.</p>
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</li>
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<li>
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<p><strong>Participation in Discussions and Votes Regarding Conflicted Matter.</strong>
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On a matter in which a PLC Person has a conflict of interest, the
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conflicted PLC Person must abstain from, and must not hear nor
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read the pre-vote discussions of the matter by the PLC or PLC
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sub-committee, except to disclose material facts and to respond to
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questions. The conflicted PLC Person shall not attempt to exert
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their personal influence with respect to the matter, either at or
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outside the meeting. The conflicted PLC Person may read minutes and/or
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logs of the matter’s discussion after voting is complete.</p>
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</li>
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<li>
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<p><strong>Participation in Votes Regarding Conflicted Matter.</strong> A conflicted
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PLC Person may not vote on the PLC action with which he or she has
|
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|
|
a conflict of interest, and shall not be present in the meeting room
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|
(or on the conference call) when the vote is taken. His or her ineligibility
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|
to vote shall be reflected in the minutes of the meeting.</p>
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</li>
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<li>
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<p><strong>Conflicted Persons Cannot Establish Quorum.</strong> A conflicted
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PLC Person shall not be determining the presence of a quorum for purposes
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|
|
of a vote on the matter where he or she has a conflict of interest.</p>
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</li>
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</ul>
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<h3 id="procedures-for-conservancy-retaining-plc-persons-services">Procedures for Conservancy Retaining PLC Person’s Services</h3>
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<p>Notwithstanding the above, Conservancy acknowledges that many PLC
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Persons are technical service contractors (e.g., software developers,
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|
documentation writers, website developers, etc.) who can provide professional
|
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|
services useful to advance computing and contribute to Conservancy’s mission.
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|
In many instances, a PLC Person will have the strongest mix of credentials,
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|
|
experience, and interest and availability to fulfill a technical service
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|
|
contract desired by Conservancy and/or a Project. To address those
|
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|
instances, Conservancy requests Projects to follow the following procedures.</p>
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<ul>
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|
<li>
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|
<p><strong>Drafting the Technical Service Proposal.</strong> PLCs must draft
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|
a written proposal for every technical service project their Project
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|
|
wishes to fund. During the drafting process, if a PLC Person (or his
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|
or her family member), a PLC Person’s employer and/or a fellow employee
|
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|
|
of PLC Person’s employer wish to be considered a candidate to fulfill
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|
|
the funded technical service contract, that PLC Person has a conflict
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|
of interest and must recuse herself or himself from the proposal drafting
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|
process, except to disclose material facts and to respond to questions,
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|
|
and must abstain from any vote to approve that proposal. All other
|
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|
procedures as outlined in
|
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|
<a href="#conflict-resolution-procedures-for-plc-persons">Conflict Resolution Procedures for PLC Persons</a>
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|
|
shall still apply. The PLC must document the PLC Person’s abstention from the
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|
|
proposal drafting process in the minutes of the next PLC meeting.</p>
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|
</li>
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<li>
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|
<p><strong>Selecting a PLC Person to Fulfill a Contract.</strong> Once a PLC
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|
has drafted and approved a technical service proposal, the PLC is free to
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|
|
consider qualified candidates to fulfill the funded contract. If the
|
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|
|
PLC wishes to recommend that Conservancy contract with a PLC Person
|
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|
|
to carry out the work, the following criteria must be met:</p>
|
|
|
|
</li>
|
|
|
|
<li>
|
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|
|
<p><strong>Suggested Compensation.</strong> The PLC must provide Conservancy’s
|
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|
|
Executive Director (or designee) with a suggested compensation (converted
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|
|
into an hourly wage) for the technical service contractor to be retained to
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|
|
fulfill the funded contract.</p>
|
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|
|
</li>
|
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|
|
<li>
|
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|
|
<p><strong>Independent Assessment of Credentials.</strong> The PLC (or an unaffiliated
|
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|
|
PLC Person) must provide Conservancy’s Executive Director (or designee)
|
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|
|
with a written assessment as to why the PLC Person is uniquely qualified
|
|
|
|
to fulfill the funded contract.</p>
|
|
|
|
</li>
|
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|
<li>
|
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|
|
<p><strong>Conservancy Retains Right to Request Competitive Bids.</strong> PLCs
|
|
|
|
acknowledge that Conservancy retains the right to ask for bids from
|
|
|
|
technical service contractors in addition to PLC Person to fulfill a given contract.
|
|
|
|
Should that instance arise, Conservancy’s Executive Director (or designee)
|
|
|
|
will consult with the PLC to select the candidate best suited to fulfill
|
|
|
|
the contract within the budget allotted.</p>
|
|
|
|
</li>
|
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|
|
<li>
|
|
|
|
<p><strong>Conservancy holds Sole Authority to Negotiate and Execute Contracts.</strong>
|
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|
|
PLCs acknowledge that Conservancy holds sole authority
|
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|
|
to negotiate and execute contracts on behalf of Member Projects. In
|
|
|
|
turn, Conservancy pledges to negotiate all contracts zealously, putting
|
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|
|
the best interests of the affected Member Project first. To avoid
|
|
|
|
any conflicts, PLCs must not engage in any pre-negotiation with prospective
|
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|
|
technical service contractors – including PLC Persons – beyond collecting the terms
|
|
|
|
of the technical service contractor(s)’ bid.</p>
|
|
|
|
</li>
|
|
|
|
</ul>
|
|
|
|
<h2 id="project-community-members-participating-corporations-and-volunteers">Project Community Members: Participating Corporations and Volunteers</h2>
|
|
|
|
<p>The work accomplished by Conservancy and its Member Projects would
|
|
|
|
not be possible without the generous donation of time, funds, and
|
|
|
|
support Project Community Members – including participating corporations,
|
|
|
|
sponsors, and volunteers alike. Community members are not traditionally
|
|
|
|
considered to be “interested persons,” and all decision-making
|
|
|
|
authority rests with the PLCs and/or Conservancy.</p>
|
|
|
|
<ul>
|
|
|
|
<li><strong>Community Members Cannot Direct Funds.</strong> Community Members
|
|
|
|
are free to offer suggestions and engage in open dialogue with PLCs and/or
|
|
|
|
key developers and architects regarding a Project’s technical direction. However,
|
|
|
|
each PLC and Conservancy must together maintain sole and final control
|
|
|
|
over that Project’s technical direction and charitable mission. Community
|
|
|
|
Members who make financial donations do not receive any additional
|
|
|
|
control over a Project’s technical direction beyond what is available
|
|
|
|
to other vocal, active, and contributing community members.</li>
|
|
|
|
</ul>
|
|
|
|
<h2 id="exhibit-a-conservancy-conflict-disclosure-form">Exhibit A: Conservancy Conflict Disclosure Form</h2>
|
|
|
|
<p>Directors, Officers and Staff Members of Conservancy each have a duty
|
|
|
|
to protect Conservancy and its Member Projects from violating state
|
|
|
|
and federal laws – and to avoid any appearance of impropriety. Conservancy
|
|
|
|
Persons serve the public interest and are to have a clear understanding
|
|
|
|
of Conservancy’s charitable mission. All decisions made by Conservancy
|
|
|
|
Persons are to be made solely on the basis of a desire to promote
|
|
|
|
the best interests of Conservancy and the public good.</p>
|
2022-07-20 21:14:07 +00:00
|
|
|
<p>This Form is to be completed every one year and submitted to the
|
|
|
|
Chairperson of Conservancy’s Board</p>
|
2019-03-12 14:24:36 +00:00
|
|
|
<p>Date: <code>__________________________</code></p>
|
2022-07-20 21:14:07 +00:00
|
|
|
<p>Next Form to be completed by (one year from now): <code>__________________</code></p>
|
2019-03-12 14:24:36 +00:00
|
|
|
<p>Name: <code>__________________________</code></p>
|
|
|
|
<p>Position (employee/officer/trustee): <code>_________________________________</code></p>
|
|
|
|
<p>I affirm the following:</p>
|
|
|
|
<ul>
|
|
|
|
<li>
|
|
|
|
<p>I have received a copy of the Software Freedom Conservancy Conflict
|
|
|
|
of Interest Policy. <code>__________________</code> (initial)</p>
|
|
|
|
</li>
|
|
|
|
<li>
|
|
|
|
<p>I have read and understand the policy. <code>_________</code> (initial)</p>
|
|
|
|
</li>
|
|
|
|
<li>
|
|
|
|
<p>I agree to comply with the policy. <code>_________</code> (initial)</p>
|
|
|
|
</li>
|
|
|
|
<li>
|
|
|
|
<p>I understand that Conservancy is a public charity and in order to
|
|
|
|
maintain its federal tax exemption it must engage primarily in activities
|
|
|
|
which accomplish one or more of tax-exempt purposes. <code>_________</code> (initial)</p>
|
|
|
|
</li>
|
|
|
|
</ul>
|
|
|
|
<p>Disclosures:</p>
|
|
|
|
<p>Please describe below any relationships, transactions, positions you
|
|
|
|
(or your family member) hold, or any other circumstances that you
|
|
|
|
believe could cause a conflict of interest as defined by the Policy
|
|
|
|
between your duty to Conservancy and your personal interests, financial
|
|
|
|
or otherwise:</p>
|
|
|
|
<p><code>________</code> I have no conflicts to report</p>
|
|
|
|
<p><code>________</code> I have the following conflicts and/or potential conflicts
|
|
|
|
to report:</p>
|
|
|
|
<pre><code>__________________________________________________________________________
|
|
|
|
|
|
|
|
__________________________________________________________________________
|
|
|
|
|
|
|
|
__________________________________________________________________________
|
|
|
|
|
|
|
|
__________________________________________________________________________
|
|
|
|
|
|
|
|
__________________________________________________________________________
|
|
|
|
</code></pre>
|
|
|
|
<p>I hereby certify that the information set forth is true and complete
|
|
|
|
to the best of my knowledge.</p>
|
|
|
|
<p>Signature: <code>______________________________________</code></p>
|
|
|
|
<p>Date: <code>_________________</code></p>
|
|
|
|
<h2 id="exhibit-b-project-leadership-committee-conflict-disclosure-form">Exhibit B: Project Leadership Committee Conflict Disclosure Form</h2>
|
|
|
|
<p>Each volunteer, academic and/or industry professional that serves
|
|
|
|
on a Conservancy Member Project’s Project Leadership Committee (PLC)
|
2022-07-20 21:14:07 +00:00
|
|
|
have a duty to act in the best interests of their Project when
|
2019-03-12 14:24:36 +00:00
|
|
|
making decisions about the Project’s technical direction. Every committee
|
|
|
|
member must also abide by New York State and USA federal laws associated with non-profit
|
|
|
|
organizational governance.</p>
|
|
|
|
<p>Committee members must complete this form annually and submit it to
|
2022-07-20 21:14:07 +00:00
|
|
|
their PLC and to Conservancy’s Executive Director.</p>
|
2019-03-12 14:24:36 +00:00
|
|
|
<p>Date: <code>_____________</code></p>
|
|
|
|
<p>Next Form to be completed by (one year from now): <code>___________</code></p>
|
|
|
|
<p>Name: <code>____________________________________</code></p>
|
|
|
|
<p>Position (if applicable): <code>________________________________</code></p>
|
|
|
|
<p>Employer (if student or self-employed, please indicate): <code>________________________________</code></p>
|
|
|
|
<p>I affirm the following:</p>
|
|
|
|
<ul>
|
|
|
|
<li>
|
|
|
|
<p>I have received a copy of the Software Freedom Conservancy Conflict
|
|
|
|
of Interest Policy. <code>_________</code> (initial)</p>
|
|
|
|
</li>
|
|
|
|
<li>
|
|
|
|
<p>I have read and understand the policy, in particular, Section 3 (relating
|
|
|
|
to PLCs). <code>_________</code> (initial)</p>
|
|
|
|
</li>
|
|
|
|
<li>
|
|
|
|
<p>I agree to comply with the policy. <code>_________</code> (initial)</p>
|
|
|
|
</li>
|
|
|
|
<li>
|
|
|
|
<p>I understand that Conservancy is a public charity and in order to
|
|
|
|
maintain its federal tax exemption it must engage primarily in activities
|
|
|
|
which accomplish one or more of tax-exempt purposes. <code>_________</code> (initial)</p>
|
|
|
|
</li>
|
|
|
|
</ul>
|
|
|
|
<p>Disclosures:</p>
|
|
|
|
<p>Please describe below any relationships, transactions, positions you
|
|
|
|
(or your family member) hold, or any other circumstances that you
|
|
|
|
believe could cause a conflict of interest as defined by the Policy
|
|
|
|
between your duty to your Project and your personal interests, financial
|
|
|
|
or otherwise:</p>
|
|
|
|
<p><code>________</code> I have no conflicts to report</p>
|
|
|
|
<p><code>________</code> I have the following conflicts and/or potential conflicts
|
|
|
|
to report:</p>
|
|
|
|
<pre><code>__________________________________________________________________________
|
|
|
|
|
|
|
|
__________________________________________________________________________
|
|
|
|
|
|
|
|
__________________________________________________________________________
|
|
|
|
|
|
|
|
__________________________________________________________________________
|
|
|
|
|
|
|
|
__________________________________________________________________________
|
|
|
|
</code></pre>
|
|
|
|
<p>I hereby certify that the information set forth is true and complete
|
|
|
|
to the best of my knowledge.</p>
|
|
|
|
<p>Signature: <code>________________________________________</code></p>
|
|
|
|
<p>Date: <code>____________________________________</code></p>
|
|
|
|
|
|
|
|
{% endblock %}
|