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State of California DUTY STATEMENT MSH3002 (Rev. 9/26/16) Employee Name Position No / AgencyUnitClassSerial 4875007500003 Class Title Clinical Administrator Metropolitan SUBJECT TO CONFLICT OF INTEREST

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How to fill out conflict of interest

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Identify potential conflicts of interest.

02

Disclose any potential conflicts of interest to the appropriate parties.

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Evaluate the potential conflicts of interest and determine if any actions need to be taken to mitigate them.

04

Document all conflicts of interest and the steps taken to address them.

Who needs conflict of interest?

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Anyone involved in a decision-making process where they could potentially benefit financially or personally from the outcome.

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Individuals in positions of authority or influence within an organization.

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What is conflict of interest?

Conflict of interest refers to situations in which an individual or organization is involved in multiple interests, financial or otherwise, and serving one interest could involve working against another.

Who is required to file conflict of interest?

Those who are in positions where potential conflicts of interest may arise, such as government officials, board members, and employees of organizations, are usually required to file conflict of interest disclosures.

How to fill out conflict of interest?

Conflict of interest forms typically require individuals to disclose any financial interests, relationships, or activities that could potentially influence their decisions or actions.

What is the purpose of conflict of interest?

The purpose of conflict of interest policies is to promote transparency and integrity in decision-making processes and to prevent individuals from abusing their positions of authority for personal gain.

What information must be reported on conflict of interest?

Information that must be reported on conflict of interest forms may include financial holdings, investments, employment relationships, family relationships, and other potential conflicts of interest.

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