This form may be used for disclosures of potential Conflicts of Interest/Conflicts of Commitment whenever they occur and throughout the year. 

PLEASE NOTE: Annual and Research Reporting disclosures are required separately from this form and occur as follows:

  1. Annual Reporting takes place in the fall each year and is completed in MyInfo. 
  2. Research Reporting takes place internally within the Office of Sponsored Programs ePCF

 denotes required fields.

Personal Information
Disclosures - Please disclose any new conflicts of interest/conflicts of commitment
The information contained in this form is complete and accurate to the best of my knowledge, and I acknowledge my continuing obligation to update my disclosure when there is a significant change in my personal or financial interests creating potential Conflicts of Interest/Conflicts of Commitment. The Office of Research Compliance will determine if the conflict can be managed and institute a Conflict of Interest Management Plan if appropriate.