DECLARATION OF OUTSIDE INTERESTS NAME PLEASE DECLARE BELOW

DECLARATION BY THE NOMINATED ADVISER PURSUANT TO THE
DECLARATION OF ABANDONMENT STATE OF LOUISIANA PARISH
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(declaration Letter to be Submitted to Ura) to Chief
(LETTERHEAD OF COMPANY) OWN PRODUCTION DECLARATION TO THE GOVERNMENT
(TRANSLATION) NANNING DECLARATION ON CHINAASEAN HEALTH COOPERATION AND DEVELOPMENT


DECLARATION OF OUTSIDE INTERESTS NAME PLEASE DECLARE BELOW


Declaration of Outside Interests


DECLARATION OF OUTSIDE INTERESTS NAME PLEASE DECLARE BELOW


DECLARATION OF OUTSIDE INTERESTS NAME PLEASE DECLARE BELOW DECLARATION OF OUTSIDE INTERESTS NAME PLEASE DECLARE BELOW DECLARATION OF OUTSIDE INTERESTS NAME PLEASE DECLARE BELOW Name:

DECLARATION OF OUTSIDE INTERESTS NAME PLEASE DECLARE BELOW


Please declare below any outside interest(s) which could give rise to potential conflict with official duties as Permanent Secretary or which could be subject to perceptions of unfair advantage in the recruitment process.


Conflict can extend to an applicant’s personal/business relationships and these should also be declared. The following relationship categories apply:

  1. Immediate family -This is defined as self, spouse or partner, in-laws and step relations to the extent of parents, siblings, children, grand-parents.

  2. Business associates of self, spouse or partner, including the immediate family of those associates.

  3. Others including close friends and those with whom you have regular dealings (business or personal) who would be regarded as an NICS “customer” within the current scope of responsibility for transactions relating to NICS business.

Please provide as much detail as possible. In general conflict of interest could arise in two particular areas:

  1. Conduct of Private Businesses.

  2. Conduct of Private Activities.


Completed forms should be returned to [email protected]

Do you have any outside interest(s) which could give rise to potential conflict with official duties or which could be subject to perceptions of unfair advantage?


DECLARATION OF OUTSIDE INTERESTS NAME PLEASE DECLARE BELOW Yes - now complete parts 2 and/or 3 (as appropriate) and 4


DECLARATION OF OUTSIDE INTERESTS NAME PLEASE DECLARE BELOW No - now complete part 4




DECLARATION OF OUTSIDE INTERESTS NAME PLEASE DECLARE BELOW


If an applicant operates or is involved in a private business the following points should be considered carefully:


  1. the separation of activities associated with running the business and official duties, and

  2. the links between that business and the NICS.


Name/ Relationship

Business Name

Description of business activities/Dept References

Involved in Government Contracts/Tenders (Yes/No) If Yes, provide full details

Self




(immediate family, business associate or other)








If an applicant operates or is involved in private activities the following points should be considered carefully:


  1. the separation of activities which could be associated with official duties. and


  1. the links between those activities and the NICS.


Name/Relationship

Business/ Organisation Name

Description of purpose/ role of business/ Organisation

Role/Position held within business/ Organisation

Self




(immediate family, business associate or other)







Where situations occur where it could be perceived by the public or others that a conflict of interest in my application/appointment might arise as a result of my private business activities or personal relationships, I accept that I must immediately inform NICSHR at scs[email protected]


I also accept that I must notify NICSHR immediately of any changes of circumstances which would be likely to give rise to a conflict of interest.


The information contained in this declaration is complete at today’s date and no information has been withheld knowingly by me.


Signed: Date:








Describe the potential conflict

Can measures be taken to reduce the potential for conflict

- Yes/No

Outline these measures

Are you content that once implemented the potential for conflict is sufficiently removed?

-Yes/No








The NICS takes data protection, freedom of information and environmental information issues seriously. It takes care to ensure that any personal information received from you is dealt with in a way which complies with the requirements of the General Data Protection Regulation (2016). This means that any personal information you supply will be processed principally for the purpose for which it has been provided. However, the NICS is under a duty to protect the public funds it administers, and to this end may use the information you have provided for this purpose.

If you are content that, after consideration of the facts, you can implement appropriate measures to mitigate against both potential conflict and the perception of unfair bias or advantage, please sign the declaration below.



Name

Completed forms should be returned to [email protected]

































022011 SUPP (CRICCRC1) SUPERVISOR STANDARD AND DECLARATION FORM
022011 SUPP(CRI3) SUPERVISOR STANDARD AND DECLARATION FORM USE
1 IDENTIFICATION DE LA DECLARATION 11 CHANGEMENT


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