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Use the Financial Conflict of Interest Report form for all interests required to be disclosed that impact the employment or obligations as an official of an employee with the company.
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Financial Conflict of Interest Report
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How to write my Financial Conflict of Interest Report document

company name Conflict of Interest and Disclosure Report Employee. contract first name contract last name Department. department Supervisor. supervisor manager Job title of signator authorized signature or signer. Insert Employee Title Address Phone Insert Employee Address and Phone Employee Job Information Position. contract job title Date of Hire. Work Type. Hourly Salary Shift Type. Day Night Swing Other Instructions. Use this form for all interests required to be disclosed that impact your employment and or obligations as an official with company name and comply with Insert your State or Company Policy Reference here or let this stand as is. This report must be filed annually for all Directors and Officers. Additional sheets may be attached as necessary. Supervisor must complete the following form and file it with the Human Resources Department. IMPORTANT. When answering each question in this form you must include sources of income and disclosures as they apply to your spouse and dependent children. Disclosures Sources of Income

Please list all your sources of income of more than 600 per year. Sources of income to list include salaries hourly employment directorships dividend and investment income interest payments annuities or other settlements. Investments and Ownership Please list any investments in or ownership of public or private corporations stock or other business organizations that are in excess of or constitute 5% or greater ownership stake. You are not required to list specific amounts of your investments. Instead you should specify as an example that you have an investment in xyz firm who is in the abc industry. Lobbying and Retainer Fees Please list any persons firms or organizations for whom lobbying compensated or not is performed by you or your family members. Please include non dependent children in your answer for this question.

Professional Services Please list all professional services you or your spouse provide such as attorney accountant or consultant and the interests that you provide them for as general overview e. g. industry company type etc. Bankruptcy Please list any bankruptcy default or discharge of debt received in any United States District Court within the last ten years of the date on this form. Loans and Debt Please list all loans or combination of loans that total more than from the same source. Private loans made to family or children are not required to be disclosed provided that you are not co signer on an instrument of debt for loan made to family or children. Additional Information

Please list all other financial disclosures or disclosures of employment offices or positions held public service or legislative employment or any other disclosure you want to make. Employee Officer Signature Date Supervisor Signature Date For Office Use Only Received By signator authorized signature or signer. Human Resources Manager Date hr human resources contact name hr human resources phone hr human resources email

address address city state or province zip or postal code Phone phone number

How do you write a Conflict of Interest Policy document? (alternate or related contract document)

company name CONFLICT OF INTEREST POLICY Summary. The purpose of this company policy is to set forth definitions of what the company considers to be conflict of interest for its employees their family members or any other organization group or third party they may be affiliated with or actively involved with that may be seen as competing with the interests of company name or benefiting in some undue way from proprietary information services products or direct financial consideration. The following shall apply to all company name employees managers and executives. 1. An employee may not accept any gift that might benefit or appear to benefit the employee or the employees family due to that employees connection to the company without first disclosing the facts of the offer of such gift to management and receiving in writing approval prior to acceptance of such gift. Gifts include but are not limited to tangible objects products entertainment loans services or promises of future benefits. The only exception to this rule shall be gifts of nominal value or promotional items with value no greater than 25. 00. 2. An employee or his her family may not perform services in exchange for compensation for company name its subsidiaries business units vendors or suppliers unless management approves and has previously determined that no conflict of interest arises from such transactions. Under this policy an employees everyday duties shall not be considered services unless said services result in extra compensation outside of the employees employment salary or contract.

3. Any employee or member of his her family shall not have any beneficial interest in or substantial obligation to any company name supplier or any other organization that is engaged in doing business with or serving company name unless the Executive Director has determined on the basis of full disclosure of facts and prior to obtaining said interest or obligation or incurring said obligation that such interest obligation does not constitute conflict of interest. 4. Any employee or any member of his her family acting as group or individually or on behalf of any organization or business to which he she has allegiance shall not use his her position for personal professional political or monetary gain. An employee is not precluded from making neutral statement regarding his her affiliation with company name. Acknowledgment of Agreement and Compliance I have reviewed the above referenced policy regarding conflict of interest and proprietary and confidential information. agree to comply with it and further state that have not knowingly been party to conflict of interest that has not been previously disclosed to the Executive Director. I further agree to report any potential conflicts of interest to the Executive Director prior to engaging in or participating in any action or affiliation which may be conflict of interest during the term of my employment. I agree to comply with the proprietary and confidential information provisions of this policy throughout my employment and thereafter. Date Signature Witnessed By signator authorized signature or signer.

Job title of signator authorized signature or signer. Date when the contact was signed

How do you write a Employment Interview Rejection Letter document? (example of another included contract document)

EMPLOYMENT INTERVIEW REJECTION LETTER current date contract first name contract last name Address of Inquirer Re. Your employment inquiry with company name Dear contract first name contract last name

Thank you for your interest in Insert Position This letter is to confirm our receipt of your information and to let you know of determination by company name that an interview would not be mutually beneficial for the position we currently have open. We will keep your resume and application on file and will notify you of any future considerations or opportunities. We appreciate your interest in company name and wish you well. Respectfully company name By signator authorized signature or signer.

Job title of signator authorized signature or signer. Date when the contact was signed Human Resources Department

Writing the Employment Verification Letter document (example of another included contract document)

company name EMPLOYMENT VERIFICATION LETTER current date Re. company name Employment Verification Letter To Whom It May Concern. This letter is to confirm that contract first name contract last name has been employed with us in good standing since Employment Start Date on full time basis as contract job title at current annual salary of insert dollar amount If salary or location information is confidential or not required for verification you can remove those sections. Depending on the situation this may not be given out for security or privacy issues. The branch location where the employee works is. company name

address address city state or province zip or postal code Phone. phone number Please feel free to contact our Human Resources department at the number above if you require assistance or any additional information. I certify that the above information is current as of current date.

company name By signator authorized signature or signer. Job title of signator authorized signature or signer. Date when the contact was signed Human Resources Department

Writing the Drug and Alcohol Testing Consent Form document (example of another included contract document)

company name CONSENT FOR DRUG AND ALCOHOL TESTING current date Instructions. As condition of employment with company name or for an application for employment to be considered you will be required to submit to testing for drug and or alcohol use. If the test results are positive you cannot be employed by company name for any reason. You must be at least years of age to agree to this consent form. If you are not at least years of age you must additionally get parent or guardian to sign this form in the space provided below. I understand the reason for this drug and alcohol test and do hereby freely give my consent to have this test taken as condition of my employment with company name. also understand that the results of this test shall be made available to company name and become part of my permanent record with company name.

I further understand that if my test results come back as positive for either drugs or alcohol shall not be considered for employment by company name. I hereby authorize any Company approved medical professional or laboratory to conduct such testing and to provide the results to company name. I understand that by signing this consent form hereby release company name and any person affiliated with company name from any liability arising out of either the testing procedure the results of such testing or any other liability or damages whether direct or indirect from undergoing this Drug and Alcohol Testing. I hereby authorize these test results to be released to company name. Print Name. Signature. Date when the contact was signed Parent or Guardian Signature.

Human Resources Department

Writing the Employment Non-Compete and Non-Disclosure document (example of another included contract document)

EMPLOYMENT AND NON DISCLOSURE AGREEMENT This Employment Agreement the Agreement is entered into this current day day of current month current year by and between company name state or province corporation hereafter Company and contract first name contract last name hereafter Employee Recitals 1. Company is in need of assistance on an hourly basis in the following areas for Companys clients Companys Client Insert Type of Work Position or Job Description Summary Here 2. Employee has agreed to perform work for Company on this project.

Declarations Pre Existing Code shall mean any method practice source code object code graphics or other resource incorporated into any deliverable. Billable Hour shall mean all hours recorded and billed to Company Client or Work Order. Bench Rate shall mean all hours recorded for internal or company related work that is not billed to Company Client or Work Order. Agreements

In consideration of the mutual covenants set forth in this Agreement Company and Employee hereby agree as follows. 1. Employee shall be available and shall provide the following efforts and services as requested. Insert Type of Work Position or Job Description Summary Here Company will compensate Employee on the following basis. hourly rate United States Dollars per billable hour Billable Hours or Client Hours 2. Employee will submit written signed reports of the time spent performing services under this Agreement itemizing in reasonable detail the date on which services were performed the number of hours spent on such date and brief description of the services rendered. Company will receive reports no less than once per month on or before the 3rd day of each month and the total amount of work will not exceed Total Amount not to Exceed United States Dollars. Company shall pay Employee all amounts due within thirty days after such reports are received. 3. Company will pay Employee for the following expenses incurred under this Agreement. * Negotiated on demand Employee shall submit written documentation and receipts itemizing the date on which such expenses were incurred. Company shall pay Employee all amounts due within thirty days after such reports are received.

4. Employee will carry general liability automobile liability and employers liability insurance in the amount of 000. 00 United States Dollars. In the event Employee fails to carry such insurance or such insurance coverage lapses while this Agreement is in effect Employee shall indemnify and hold harmless Company its agents and employees from and against any such damages claims and expenses arising out of or resulting from work conducted by Employee and its agents or employees. 5. All work will be done in competent manner in accordance with applicable standards of the profession and any specific requirements of Company contracts with clients and all services are subject to final approval by Company prior to Companys payment. 6. Employee shall make no representations warranties or commitments binding Company without Companys prior written consent. 7. In the course of performing services the parties recognize that Employee may come in contact with or become familiar with information which Company or its clients may consider confidential. This information may include but is not limited to information pertaining to design methods pricing information or work methods of Company as well as information provided by clients of Company for inclusion in work to be developed for clients which may be of value to competitors of Company or its clients. Employee agrees to keep all such information confidential and not to discuss any of it with anyone other than appropriate Company personnel or their delegates. The parties agree that in the event of breach of this Agreement damages may be difficult to ascertain or prove. The parties therefore agree that if Client breaches this Agreement Company shall be entitled to seek relief from court of competent jurisdiction including injunctive relief and shall be entitled to an award of liquidated damages in the amount of one hundred thousand dollars 100 000. 00. 8. This Agreement shall begin on start date and shall terminate on end date unless terminated for any reason by either party upon thirty days prior written notice. 9. Any notice or communication permitted or required by this Agreement shall be deemed effective when personally delivered or deposited postage prepaid by first class regular mail addressed to the other partys last known address.

10. This Agreement constitutes the entire agreement of the parties with regard to the subject matter hereof and replaces and supersedes all other agreements or understandings whether written or oral. No amendment extension or change of the Agreement shall be binding unless it is in writing and signed by all of the parties hereto. 11. This Agreement shall be binding upon and shall inure to the benefit of Company and to Companys successors and assigns. Nothing in this Agreement shall be construed to permit the assignment by Employee of any of Employees rights or obligations hereunder to any third party without Companys prior written consent. 12. All deliverables and associated documents sketches plans improvements source code or inventions developed by Employee during the term of this Agreement shall belong to Company and or its clients for whom work is being performed by Employee. Company shall retain the right to require Employee to obtain written permission prior to Employees use of any non public visual audio or other representation of deliverables so long as it is not unreasonably withheld from Employee by Company. a Third party Applications Code Objects and other Pre existing Work s. Company recognizes that certain elements of deliverables may include pre existing intellectual property Pre Existing Works that is wholly owned by the Employee. Employee grants non transferable permission to Company to use sell or otherwise distribute any deliverable that contains Pre Existing Works it gives Company during the course of this Agreement. In the event that third party resources are incorporated into deliverables presented to company it is the Employees obligation to provide list of such third party resources to Company. 13. Employee agrees to not perform business for or solicit business from Companys Clients or Vendors for period of two years from the date this Agreement is signed without prior written permission from Company. 14. This Agreement shall be governed by and construed in accordance with the laws of the State of state or province. Exclusive jurisdiction and venue shall be in the county County state or province Superior Court. The prevailing party shall be entitled to recover its reasonable attorney fees and statutory costs. If any portion of this Agreement is declared unenforceable that portion shall be construed to give it the maximum effect possible and the remainder of this Agreement shall continue in full force and effect. All parties represent and warrant that on the date first written above they are authorized to enter into this Agreement in its entirety and duly bind their respective principals by their signatures below. EXECUTED as of the date first written above. Employee

By signator authorized signature or signer. Job title of signator authorized signature or signer. Date when the contact was signed company name By signator authorized signature or signer. Job title of signator authorized signature or signer. Date when the contact was signed Company Initials Employee Initials

How do you write a Employment Offer Rejection Letter document? (example of another included contract document)

POST INTERVIEW DECLINE OF OFFER OF EMPLOYMENT current date contract first name contract last name Address of Job Candidate Re. Your interview with company name Dear contract first name contract last name.

Thank you for taking the time to interview with us for the position of Insert Position We regret to inform you that the position has been filled. We will keep your information on file and notify you of any future opportunities with our company. We appreciate your interest in company name and wish you well. Respectfully company name By signator authorized signature or signer. Job title of signator authorized signature or signer. Date when the contact was signed Human Resources Department

How to write my Applicant Consent to Release Information document (example of another included contract document)

APPLICANTS CONSENT TO RELEASE INFORMATION current date Instructions. In order to consider an application for employment with company name each applicant must authorize company name to make inquiries. This consent form allows company name to gather the required information from the parties listed during the application process. You must be at least years of age to agree to this consent form. If you are not at least years of age you must additionally get parent or guardian to sign this form in the space provided below. I contract first name contract last name authorize company name to inquire and request information about my educational qualifications and past employers. I also understand that the results of these inquiries shall be made available to company name and become part of my permanent record with company name.

I hereby authorize any company name approved staff or third party designee to conduct such inquiries and authorize all past employers educational institutions service organizations volunteer groups or any other organization or certifying body to release information to company name. The following information is approved for release. * Any information requested by company name * Date of employment * Salary history and compensation * Position held or title

* Job description and area of responsibility * Attendance absenteeism information * Degrees obtained credits earned transcripts Print Name. Social Security Number TIN ID

Signature. Date when the contact was signed Parent or Guardian Signature. Human Resources Department

A Document from Contract Pack

The editable Financial Conflict of Interest Report template - complete with the actual formatting and layout is available in the retail Contract Packs.
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