APPENDIX A: Federal Forms Administration for Children and Families U.S. Department of Health and Human Services Certification Form Regarding Conflict Of Interest, Confidentiality and for Reviewers of Grant Applications Reviewers are individually responsible for evaluating their own affiliations and financial interest, and those of their close relatives and professional associates that relate to their duties as reviewers before they review any applications. Conflict of interest is defined as: any action by a reviewer in the grants review or awarding process that would affect, or could appear to affect, the financial interest, or would cause the reviewer’s reviewer’s impartiality in the grants process to be questioned. Specific situations include, but are not limited to, the following: a reviewer may not participate in the review or award of a specific grant application in which any of the following has a financial interest: the reviewer, the spouse, parent, child, or partner; reviewer’s any organization (including a parent or subsidiary) in which the reviewer, the spouse, reviewer’s parent, child, or partner serves as officer, director, trustee, partner or is otherwise similarly associated; any organization (including a parent or subsidiary) in which the reviewer, the spouse, reviewer’s parent, child, or partner is negotiating for or has an arrangement concerning prospective employment or other similar association; or
APPENDIX A: Federal Forms Administration for Children and Families U.S. Department of Health and Human Services Certification Form Regarding Conflict Of Interest, Confidentiality and for Reviewers of Grant Applications Reviewers are individually responsible for evaluating their own affiliations and financial interest, and those of their close relatives and professional associates that relate to their duties as reviewers before they review any applications. Conflict of interest is defined as: any action by a reviewer in the grants review or awarding process that would affect, or could appear to affect, the reviewer’s financial interest, or would cause the reviewer’s impartiality in the grants process to be questioned. Specific situations include, but are not limited to, the following: a reviewer may not participate in the review or award of a specific grant application in which any of the following has a financial interest: the reviewer, the reviewer’s spouse, parent, child, or partner; any organization (including a parent or subsidiary) in which the reviewer, the reviewer’s spouse, parent, child, or partner serves as officer, director, trustee, partner or is otherwise similarly associated; any organization (including a parent or subsidiary) in which the reviewer, the reviewer’s spouse, parent, child, or partner is negotiating for or has an arrangement concerning prospective employment or other similar association; or