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Get the free Disclosure Statement for Certain Academic Employees - qcc cuny

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This document serves as a financial disclosure statement for academic employees at CUNY applying for external grants or contracts, ensuring compliance with State Ethics Commission requirements.
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How to fill out disclosure statement for certain

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How to fill out Disclosure Statement for Certain Academic Employees

01
Obtain the Disclosure Statement form from your institution's website or the academic office.
02
Read the instructions carefully to understand the requirements.
03
Fill in your personal details such as name, position, and contact information at the top of the form.
04
Provide a brief description of your job responsibilities and any external employment or consulting agreements.
05
Disclose any potential conflicts of interest, including financial interests or relationships that may affect your academic responsibilities.
06
Review the completed form for accuracy and completeness.
07
Sign and date the form at the designated areas.
08
Submit the form to the appropriate office or department as instructed.

Who needs Disclosure Statement for Certain Academic Employees?

01
Any academic employees involved in teaching, research, or administration at the institution.
02
Individuals who have potential conflicts of interest related to their professional duties.
03
Employees who engage in external consulting or collaborations that may impact their institutional responsibilities.
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A disclosure statement is a financial document presented to a participant in a transaction that explains key information in plain language. These are provided for retirement plans to spell out the plan's rules, and with the contract for mortgages, auto, personal, and other kinds of loans.
A Disclosure Statement is a document or section within a document that provides essential information, facts, or details about a particular subject relevant to a contract or transaction. It ensures that all parties involved have a clear understanding of material facts, potential risks, liabilities, and obligations.
The Standard Contents of a Professional Disclosure Statement Your qualifications, including education, training and experience. Your practice philosophy. The professional code of ethics you adhere to. The services you offer.
I hereby certify that, to the best of my knowledge, neither I (including any member of my immediate family) nor any individual or entity with whom or wijt h which I have a significant working relationship have (has) received something of value from a commercial party related directly or indirectly to the subject of
I will keep confidential anything that you say to me, with the following exceptions: a) you direct me to tell someone else, b) I determine that you are a danger to yourself or others, c) I am ordered by a court to disclose information, d) I suspect or am made aware of physical/sexual abuse of minors, persons with
I will keep confidential anything you say as part of our counseling relationship, with the following exceptions: (a) you direct me in writing to disclose information to someone else, (b) it is determined you are a danger to yourself or others (including child or elder abuse), or (c) I am ordered by a court to disclose

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The Disclosure Statement for Certain Academic Employees is a document that requires specific academic personnel to disclose certain financial interests and relationships that could potentially influence their professional activities.
Individuals in academic positions at certain institutions, such as faculty members, researchers, and certain administrative staff who may have financial ties to outside entities, are typically required to file this statement.
To fill out the Disclosure Statement, individuals must provide detailed information regarding their external financial interests, relationships with companies, and any potential conflicts of interest, following the guidelines specified by their institution.
The purpose of the Disclosure Statement is to promote transparency and integrity in research and academic activities by ensuring that potential conflicts of interest are identified and managed appropriately.
The information that must be reported includes financial interests such as stock ownership, consulting fees, research funding from external sources, and any other relevant financial relationships that may influence the individual's work.
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