Get the free Significant Financial Interest Disclosure Form - purdue

This form is designed for External Investigators on Purdue sponsored projects to disclose Significant Financial Interests (SFI) related to their research proposals submitted to external sponsors.

How to fill out significant financial interest disclosure

How to fill out Significant Financial Interest Disclosure Form

1. Read the instructions carefully to understand the requirements.
2. Gather all relevant financial information, including stock holdings, consulting fees, and other income.
3. Fill in your name, position, and department at the top of the form.
4. List any significant financial interests you have that could be related to your work.
5. Specify the type of interest (e.g., equity, consulting fees) and provide the amount.
6. Indicate any financial interests related to research or business activities.
7. Review your entries for accuracy and completeness.
8. Sign and date the form to certify that the information is correct.

Who needs Significant Financial Interest Disclosure Form?

1. Researchers applying for funding from federal agencies.
2. Employees involved in projects with potential conflicts of interest.
3. Anyone engaged in activities that could affect their objectivity in research or professional duties.

People Also Ask about

What is an example of a no conflict of interest disclosure statement?

Example: I declare that I have no conflicts of interest related to this research/study/project. I have no personal or financial relationships that could influence my work.

What is an example of a disclosure of interest?

Example 1: If you have shares in a company that has a matter before the meeting, you are closely associated with that company. You therefore have an interest that must be disclosed. You could disclose the nature of your interest as 'I am closely associated with the company making the application'.

How do you write a disclosure of interest?

Generally speaking, disclosure statements should identify the following: The individual with the financial interest; The financial interest and/or entity creating the actual or potential conflict; and. The relationship between the financial interest and the research being presented.

What is the full form of FCOI?

Financial Conflict of Interest (fCOI) Statements.

What is an example of a disclosure statement?

A disclosure statement in such a case might read: “The author declares that (s)he has no relevant or material financial interests that relate to the research described in this paper”.

What is an example of a disclosure of interest?

Example 1: If you have shares in a company that has a matter before the meeting, you are closely associated with that company. You therefore have an interest that must be disclosed. You could disclose the nature of your interest as 'I am closely associated with the company making the application'.

What is an example of a coi statement?

I confirm that neither I nor any of my relatives nor any business with which I am associated have any personal or business interest in or potential for personal gain from any of the organizations or projects linked to XYZ AIS.

What is a significant financial interest disclosure?

Disclosure of significant financial interests means an Investigator's disclosure of significant financial interests to an Institution. Financial conflict of interest (FCOI) means a significant financial interest that could directly and significantly affect the design, conduct, or reporting of PHS-funded research.

For pdfFiller’s FAQs

What is Significant Financial Interest Disclosure Form?

The Significant Financial Interest Disclosure Form is a document used to disclose any financial interests that could potentially influence the outcomes of research or professional activities, ensuring transparency and compliance with ethical standards.

Who is required to file Significant Financial Interest Disclosure Form?

Individuals involved in research activities, such as principal investigators, co-investigators, and key personnel, are typically required to file the Significant Financial Interest Disclosure Form.

How to fill out Significant Financial Interest Disclosure Form?

To fill out the form, individuals should provide detailed information about any financial interests, including stock ownership, consulting fees, and other relevant financial relationships with organizations that may relate to their research.

What is the purpose of Significant Financial Interest Disclosure Form?

The purpose of the form is to identify potential conflicts of interest that could affect research integrity and to promote transparency in financial relationships associated with research activities.

What information must be reported on Significant Financial Interest Disclosure Form?

The form typically requires disclosure of financial interests such as ownership of stock, patents, consulting fees, research funding, or any other remunerative relationships that may be relevant to the individual's research work.