Free Declaration of Interest Template
Declaration of Interest
I. Introduction
As a [POSITION] of [YOUR COMPANY NAME], I hereby declare my interests to ensure transparency and uphold ethical standards in accordance with corporate governance principles. This Declaration of Interest is intended to disclose any potential conflicts related to my role, investments, or external affiliations within the organization.
II. Personal Information
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Name: [YOUR NAME]
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Company Name: [YOUR COMPANY NAME]
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Department: [YOUR DEPARTMENT]
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Date: [DATE OF DECLARATION]
III. Declaration of Interests
I declare the following interests that may influence or appear to influence my decision-making or actions within [YOUR COMPANY NAME]:
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Financial Interests: Any direct or indirect financial interests, including ownership of stocks, bonds, or other securities, in companies that may compete or have business relationships with [YOUR COMPANY NAME].
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Directorships or Officer Positions: Any directorships, officer positions, or advisory roles held in other companies that may pose conflicts of interest with my responsibilities at [YOUR COMPANY NAME].
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Investments: Any significant investments, partnerships, or joint ventures that could impact my impartiality or create conflicts with the interests of [YOUR COMPANY NAME].
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External Affiliations: Any memberships, affiliations, or associations with organizations or groups that could influence my decisions or actions within [YOUR COMPANY NAME].
IV. Mitigation Measures
I am committed to proactively managing and disclosing any conflicts of interest identified in this Declaration. To mitigate these conflicts and uphold the integrity of my role, I will:
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Disclose any conflicts of interest to the appropriate stakeholders within [YOUR COMPANY NAME].
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Recuse myself from decision-making processes where conflicts of interest may arise.
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Seek guidance from the Ethics Committee or relevant authority within [YOUR COMPANY NAME] regarding any uncertainties or concerns related to conflicts of interest.
V. Acknowledgment
I acknowledge that failure to disclose relevant interests may undermine trust, jeopardize corporate governance, and result in disciplinary action by [YOUR COMPANY NAME].
VI. Signature
[YOUR NAME]
Date: [DATE]
