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Research Integrity 
& Misconduct
National Security Regulations
& Related Policies
  Forms

Conflict of Interest Disclosure Forms
Bullet Federal Forms
Bullet State Forms
Bullet Form UCLA TT-100 (Inventor’s Statement Concerning Financial Interests in Candidate Licensee and Involvement in Licensing Decisions)
Bullet Disclosure Matrix (financial interest disclosure requirements)


Other Forms
Bullet Goldenrod (Request for Proposal Approval and Submission) - A link to the OCGA site

 


Federal (UCLA Form 740)

Since October 1, 1995, investigators submitting proposals to the National Science Foundation and the Public Health Services (including NIH) are required to disclose financial interests that may be related to the work performed under a sponsored project. Disclosure is required any time a proposal is submitted, when changes to financial interest(s) occur or a new investigator is added to a project for which disclosure is required.

Public Health Services agencies include the following agencies of the federal Department of Health and Human Services: the Agency for Health Care and Research (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the National Institutes of Health (NIH), and the Substance Abuse and Mental Health Services Administration (SAMHSA).

Link:

Bullet Frequently Asked Questions Concerning the Department of Health and Human Services Objectivity in Research Regulations and the National Science Foundation Investigator Financial Disclosure Policy


Federal Disclosure Forms & Guidance (Revised February 2008)

The documents are available in Acrobat Reader (PDF). Click the file names to download the files.

Document
Description
Acrobat Version (Interactive)
Form 740 Investigators' Statement of Financial Interests Form 740 (PDF)
Disclosure Supplement Supplement to Form 740 Supplement (PDF)

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State (Form 700-U)

Under California law, Principal and Co-Principal Investigators are required to disclose financial interests in a non-governmental source (such as a private agency, foundation or company) if that source (sponsor) provides support for a research project.

Link:

Bullet List of Sponsors Exempt from State Financial Disclosure


State Disclosure Forms(Revised February 2008)

The documents are available in Acrobat Reader (PDF) or Online Smart Form. Click the file name to download the desired file(s) or go to the e-form.

Document
Description
Acrobat Version (Interactive)
Online Form
Form 700-U Statement of Economic Interests for Principal Investigators Form 700-U (PDF)  
Form 700-U Addendum Investigators’ Statements of Financial Interests Addendum (PDF)  
Disclosure Supplements Supplement to Forms 700-U & 700-U Addendum Supplement (PDF)  
* Industry Clinical Trial Specific Supplement   CT Supplement
Online Smart Form
Instructions for 700-U Instructions for Completing the Statement of Economic Interests for Principal Investigators (Form 700-U) 700-U Instructions (PDF)  

Last page update on 02/08/2007

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