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State of CaliforniaHealth and Human Services AgencyDepartment of Developmental ServicesReset FormCONFLICT OF INTEREST REPORTING STATEMENT
DS 6016 (Rev. 08/2013)The duties and responsibilities of your
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How to fill out conflict of interest reporting
How to fill out conflict of interest reporting
01
Obtain a conflict of interest reporting form from the appropriate department or office.
02
Read and understand the instructions provided on the form.
03
Fill out the form completely and accurately, providing all requested information.
04
Clearly disclose any potential conflicts of interest that may exist.
05
Sign and date the form to certify the accuracy of the information provided.
06
Submit the completed form to the designated individual or office according to the established procedures.
Who needs conflict of interest reporting?
01
Employees working in organizations or companies where conflicts of interest may arise.
02
Contractors or vendors providing services to organizations.
03
Board members or executives responsible for making decisions that may be influenced by personal interests.
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What is conflict of interest reporting?
Conflict of interest reporting is the process of disclosing potential conflicts of interest that may arise in a person's professional activities.
Who is required to file conflict of interest reporting?
Certain individuals such as public officials, government employees, and members of professional organizations may be required to file conflict of interest reporting.
How to fill out conflict of interest reporting?
Conflict of interest reporting typically involves providing detailed information about any potential conflicts of interest, including financial interests, relationships, or other relevant factors.
What is the purpose of conflict of interest reporting?
The purpose of conflict of interest reporting is to promote transparency, integrity, and accountability in professional and organizational activities by identifying and managing potential conflicts of interest.
What information must be reported on conflict of interest reporting?
Information that must be reported on conflict of interest reporting may include financial assets, gifts, relationships, outside employment, and other factors that could create a conflict of interest.
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