Declaration of Interest Statement: Sample Template and Best Practices

Declaration of Interest Statement

I, 'Your Name', hereby declare the following interests that may potentially influence my actions or decisions in relation to the matter at hand:

1. Financial Interest: I have a financial interest in 'Company/ Organization Name', as I hold shares in the company. This could potentially influence my decision-making process, as I may prioritize the financial success of the company.

2. Professional Relationship: I have a professional relationship with 'Individual/ Organization Name', as I have worked with them in the past and may continue to do so in the future. This relationship might impact my judgment and objectivity when considering matters involving this individual or organization.

3. Personal Relationship: I have a personal relationship with 'Individual/ Organization Name', as they are a close friend or family member. This personal connection may affect my ability to make unbiased decisions when dealing with matters involving this person or organization.

4. Research Funding: I have received research funding from 'Organization/ Institution Name' for a project related to the subject matter under consideration. This financial support may influence my perspective and findings on the topic.

I acknowledge that these declared interests may potentially create a conflict of interest or bias in my decision-making process. However, I assure that I will strive to maintain transparency, objectivity, and fairness in all my actions and decisions.

I understand the importance of acting in the best interest of all stakeholders involved and will disclose any relevant interests in a timely manner. Furthermore, I will recuse myself from any decision-making process where my declared interests could compromise the integrity of the outcome.

By signing this declaration, I affirm that all the information provided is accurate and complete to the best of my knowledge.

'Your Name' 'Date'