Conflict of Interest Declaration Example
Example document for Conflict of Interest Declaration. Use this as a reference when creating your own.
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Document: Conflict of Interest Declaration
Example Document
Last updated 7/30/2026
Example: IT Procurement Conflict
Name: Jane Smith Position: IT Procurement Manager Date: 15/03/2026
Declaration
I declare that my spouse, John Smith, owns 30% of TechSupply Pty Ltd, which has been shortlisted for the server infrastructure contract valued at $250,000.
Management Plan
- I will recuse myself from the evaluation panel
- I will have no involvement in the procurement decision
- The evaluation will be conducted by an independent panel
- I will not access any tender documents from TechSupply Pty Ltd
Signature: J. Smith Date: 15/03/2026
Notes
This example shows a typical familial and financial conflict in a procurement context. The management plan removes the person from all aspects of the decision.
About this Example
Part of the Conflict of Interest Declaration document collection
Document Type
Conflict of Interest Declaration
A formal declaration form for disclosing actual, potential, or perceived conflicts of interest in a workplace or governance setting.