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Community Foundation of Hancock County

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CFHC CONFIDENTIALITY COMMITMENT AND CONFLICT OF INTEREST DISCLOSURE

Please refer to our Conflict of Interest Policy and Confidentiality Policy before completing and submitting this form.

    If yes, disclose the organization(s) and your relationship to the organization(s).
    If yes, disclose your relationship to the individual, the organization(s) they are affiliated with and your relationship to the organization(s).
    If yes, disclose the organization(s) and your relationship to the organization(s).
    If yes, disclose your relationship to the individual, the organization(s) they are affiliated with and your relationship to the organization(s).
  • I have read CFHC's Conflict of Interest policy approved by the Board of Directors and understand that as an Employee/Director/Officer of CFHC, it is my obligation to act in a manner that promotes the best interests of CFHC and to avoid conflicts of interest when making decisions and taking actions on behalf of CFHC.

    My answers to this disclosure form are correctly stated to the best of my knowledge and belief. Should a possible conflict of interest arise in my responsibilities to CFHC, I recognize that I have the obligation to notify, based on my position, the appropriate designated individual (Chairman, President), and to abstain from any participation in the matter until CFHC can determine whether a conflict exits and how that conflict shall be resolved. If any relevant changes occur in my affiliations, duties, or financial circumstances, I recognize that I have a continuing obligation to file an amended "Conflict of Interest Disclosure Form" with the appropriate designated office.

    I have read and understand the Confidentiality Policy and shall exercise care not to disclose confidential information in connection with my affiliation with CFHC.

    I understand that the information on this form is solely for use by CFHC and is considered confidential information. Release of this information within CFHC will be on a need-to-know basis only. Release to external parties will be only when required by law.
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Community Foundation of Hancock County
312 East Main Street
Greenfield, Indiana 46140

Phone 317-462-8870
Office Hours Monday - Friday, 8 a.m. - 4 p.m.

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