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This document is a disclosure form required for principal investigators applying for grants from U.S. Public Health Service agencies, outlining any significant financial interests that must be reported
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How to fill out U.S. Public Health Service Grant Application Significant Financial Interests Disclosure

01
Gather your financial information, including any income, investments, and ownership interests.
02
Download the U.S. Public Health Service Grant Application Significant Financial Interests Disclosure form from the official website.
03
Fill out your personal information, including your name, position, and institutional affiliation.
04
List any significant financial interests relevant to the research project, including any income over $5,000, equity interests, and intellectual property rights.
05
Disclose any financial interests related to institutions or organizations that could be affected by the research.
06
Review the disclosures to ensure accuracy and completeness.
07
Sign and date the form to certify that the information provided is true and complete.
08
Submit the completed form as part of your grant application to the appropriate funding agency.

Who needs U.S. Public Health Service Grant Application Significant Financial Interests Disclosure?

01
Researchers applying for U.S. Public Health Service grants.
02
Institutions receiving funding from U.S. Public Health Service grants.
03
Individuals with financial interests that could potentially influence research outcomes.
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Definition: Financial interest refers to any advantage or profit of a financial nature that a person desires. It can also refer to a legal share or right in property. Examples: A person who invests in a company's stock has a financial interest in the company's success.
An SFI exists as defined in the following scenarios: Publicly traded entity: If the value of any remuneration received from the entity in the 12 months preceding the disclosure the value of any equity interest2 in the entity as of the date of disclosure, when aggregated, exceeds $5,000. This includes: Salary.
A financial interest is anything of monetary value (whether a dollar value can be easily determined or not) that could appear to relate to a person's roles and responsibilities at OSU.
ing to the U.S Public Health Service, a "significant financial interest" includes royalty income paid to an investigator and its disclosure is required: Only if it relates to income from publicly traded companies.
Financial Interests that must be disclosed include: Compensation/Remuneration. Equity Interests. Royalty Payments. Special Relationships. Sponsored Travel. Other Financial Interests (e.g., certain intellectual property rights)
Under 42 CFR Part 50 Subpart F and the UO's FCOI Policy, investigators responsible for the design, conduct, or reporting of sponsored research must: Disclose annually all Significant Financial Interests for themselves, their spouse, and their dependent children related to their institutional responsibilities.
An SFI exists as defined in the following scenarios: Publicly traded entity: If the value of any remuneration received from the entity in the 12 months preceding the disclosure the value of any equity interest2 in the entity as of the date of disclosure, when aggregated, exceeds $5,000. This includes: Salary.
ing to the U.S Public Health Service, a "significant financial interest" includes royalty income paid to an investigator and its disclosure is required: Only if it relates to income from publicly traded companies.

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The U.S. Public Health Service Grant Application Significant Financial Interests Disclosure is a form that researchers must complete to disclose any significant financial interests that could potentially affect their research or the integrity of the research environment.
Individuals who are applicants for U.S. Public Health Service grants or those involved in the research funded by these grants are required to file the disclosure if they have significant financial interests that could be affected by the research.
To fill out the U.S. Public Health Service Grant Application Significant Financial Interests Disclosure, an individual must provide detailed information about their significant financial interests, including amounts and nature of the interests, and how these may relate to their research.
The purpose of the Disclosure is to promote transparency and ensure that any potential conflicts of interest are identified and managed, thereby protecting the integrity of the research funded by the U.S. Public Health Service.
The information that must be reported includes details of any significant financial interests that may directly and significantly affect the design, conduct, or reporting of the proposed research, including equity interests, income, and payments from external sources.
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