Conflict of Interest Declaration (Sample Form for Company’s Employees)

CONFLICT OF INTEREST DECLARATION

Employee_________________________________________________________

Company__________________________________________________________

I acknowledge that I have read the Company policy statement concerning conflicts of interest and I hereby declare that neither I, nor any other business to which I may be associated, nor, to the best of my knowledge, any member of my immediate family has any conflict between our personal affairs or interests and proper performance of my responsibilities for the Company that would constitute a violation of that Company policy. Furthermore, I declare that during my employment, I shall continue to maintain my affairs in accordance with the requirements of the Company policy.

_________________________

Employee’s Signature

Date_____________________