Conflict of Interest Register - Sample

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Conflict of Interest Register - Sample

This is a sample register to help get you started in creating one for your own organisation.

This table registers Conflicts of Interests declared by [Org name] Board Members. It is updated following each AGM, and following the declaration of a new conflict, or change to an existing one. Refer to the Conflict of Interest Policy for full details.

Name

Position

Date Interest Advised

Interest Disclosed

Nature of potential conflict (and estimated value if known)

Action taken / Recommendations

Date implemented

Review / Comments

EXAMPLE: Kate

Treasurer

12/9/13

Brother is involved in tender selection for housing project

Kate is involved in working on the tender with the managers. Funding for the tender is $135,000

To remove any bias on the tender application, the Board has arranged for another staff member to assist the managers.

15/10/13

 

Kate had no involvement in the tender process after declaring the conflict.