Conflict of Interest Disclosure
This conflict of interest disclosure form helps organizations maintain ethical standards and regulatory compliance. Employees and board members can document financial interests, personal relationships, outside employment, and other potential conflicts. The form includes conditional sections that expand based on disclosed items and requires acknowledgment of the organization's conflict of interest policy.
Try the Form
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export function conflictOfInterestForm(form: FormTs) {
// Conflict of Interest Disclosure Form - Compliance and ethics disclosure
// Demonstrates: Checkbox, RadioButton, Datepicker, CheckboxList, Textarea, TextPanel, MatrixQuestion, conditional visibility, dynamic labels, computed values, multi-page
// State to track if any conflicts were disclosed
const hasAnyConflicts = form.computedValue(() => {
const financial = financialSection.radioButton('hasFinancialInterests')?.value() === 'yes';
const relationships = relationshipsSection.radioButton('hasRelationships')?.value() === 'yes';
const outside = outsideSection.radioButton('hasOutsideActivities')?.value() === 'yes';
const gifts = giftsSection.radioButton('receivedGifts')?.value() === 'yes';
return financial || relationships || outside || gifts;
});
// ============================================
// HEADER
// ============================================
form.addRow(row => {
row.addTextPanel('header', {
label: 'Conflict of Interest Disclosure',
computedValue: () => 'Annual disclosure of potential conflicts of interest. Please complete all sections honestly and thoroughly.',
customStyles: {
backgroundColor: '#1e293b',
color: 'white',
padding: '24px',
borderRadius: '12px',
textAlign: 'center'
}
});
});
// ============================================
// SECTION 1: Employee Information
// ============================================
const employeeSection = form.addSubform('employee', {
title: 'Your Information'
});
employeeSection.addRow(row => {
row.addTextbox('fullName', {
label: 'Full Legal Name',
placeholder: 'As it appears on official records',
isRequired: true
}, '1fr');
row.addTextbox('department', {
label: 'Department/Division',
placeholder: 'Your department',
isRequired: true
}, '1fr');
});
employeeSection.addRow(row => {
row.addTextbox('jobTitle', {
label: 'Job Title/Position',
placeholder: 'Your current title',
isRequired: true
}, '1fr');
row.addDropdown('role', {
label: 'Role Type',
options: [
{ id: 'employee', name: 'Employee' },
{ id: 'manager', name: 'Manager/Supervisor' },
{ id: 'executive', name: 'Executive/Officer' },
{ id: 'board', name: 'Board Member/Director' },
{ id: 'contractor', name: 'Contractor/Consultant' }
],
isRequired: true
}, '1fr');
});
employeeSection.addRow(row => {
row.addDatepicker('disclosureDate', {
label: 'Disclosure Date',
isRequired: true
}, '1fr');
row.addDropdown('disclosurePeriod', {
label: 'Disclosure Period',
options: [
{ id: '2024', name: 'Fiscal Year 2024' },
{ id: '2025', name: 'Fiscal Year 2025' },
{ id: '2026', name: 'Fiscal Year 2026' }
],
isRequired: true
}, '1fr');
});
// ============================================
// SECTION 2: Financial Interests
// ============================================
const financialSection = form.addSubform('financial', {
title: 'Financial Interests',
customStyles: () => {
if (financialSection.radioButton('hasFinancialInterests')?.value() === 'yes') {
return { backgroundColor: '#fef3c7', padding: '16px', borderRadius: '8px' };
}
return { padding: '16px', borderRadius: '8px', border: '1px dashed #e5e7eb' };
}
});
financialSection.addRow(row => {
row.addTextPanel('financialInstructions', {
computedValue: () => 'Do you or any immediate family member have a financial interest in any entity that does business with, or competes with, our organization?',
customStyles: {
backgroundColor: '#f1f5f9',
padding: '12px 16px',
borderRadius: '8px',
fontSize: '14px'
}
});
});
financialSection.addRow(row => {
row.addRadioButton('hasFinancialInterests', {
label: 'Financial Interest Disclosure',
options: [
{ id: 'no', name: 'No, I have no financial interests to disclose' },
{ id: 'yes', name: 'Yes, I have financial interests to disclose' }
],
orientation: 'vertical',
isRequired: true
});
});
// Financial interests detail
financialSection.addRow(row => {
row.addCheckboxList('financialTypes', {
label: 'Select all types of financial interests that apply:',
options: [
{ id: 'ownership', name: 'Ownership/Equity stake (stocks, partnership)' },
{ id: 'compensation', name: 'Compensation (salary, fees, commissions)' },
{ id: 'loans', name: 'Loans or debts' },
{ id: 'royalties', name: 'Royalties or licensing fees' },
{ id: 'board-compensation', name: 'Board/Advisory compensation' },
{ id: 'family-employment', name: 'Family member employment' }
],
orientation: 'vertical',
isVisible: () => financialSection.radioButton('hasFinancialInterests')?.value() === 'yes'
});
});
financialSection.addSpacer();
financialSection.addRow(row => {
row.addTextarea('financialDetails', {
label: 'Provide details of each financial interest:',
placeholder: 'For each interest, describe: (1) Entity name, (2) Nature of interest, (3) Approximate value, (4) How it relates to our organization',
rows: 4,
autoExpand: true,
isRequired: () => financialSection.radioButton('hasFinancialInterests')?.value() === 'yes',
isVisible: () => financialSection.radioButton('hasFinancialInterests')?.value() === 'yes'
});
});
// ============================================
// SECTION 3: Personal Relationships
// ============================================
const relationshipsSection = form.addSubform('relationships', {
title: 'Personal Relationships',
customStyles: () => {
if (relationshipsSection.radioButton('hasRelationships')?.value() === 'yes') {
return { backgroundColor: '#fef3c7', padding: '16px', borderRadius: '8px' };
}
return { padding: '16px', borderRadius: '8px', border: '1px dashed #e5e7eb' };
}
});
relationshipsSection.addRow(row => {
row.addTextPanel('relationshipInstructions', {
computedValue: () => 'Do you have any close personal relationships (family, romantic, close friendships) with vendors, contractors, competitors, or other employees that could influence your business decisions?',
customStyles: {
backgroundColor: '#f1f5f9',
padding: '12px 16px',
borderRadius: '8px',
fontSize: '14px'
}
});
});
relationshipsSection.addRow(row => {
row.addRadioButton('hasRelationships', {
label: 'Relationship Disclosure',
options: [
{ id: 'no', name: 'No, I have no relationships to disclose' },
{ id: 'yes', name: 'Yes, I have relationships to disclose' }
],
orientation: 'vertical',
isRequired: true
});
});
relationshipsSection.addRow(row => {
row.addCheckboxList('relationshipTypes', {
label: 'What types of relationships exist?',
options: [
{ id: 'spouse', name: 'Spouse/Domestic Partner' },
{ id: 'parent-child', name: 'Parent/Child' },
{ id: 'sibling', name: 'Sibling' },
{ id: 'extended-family', name: 'Extended family' },
{ id: 'romantic', name: 'Romantic partner' },
{ id: 'close-friend', name: 'Close personal friend' },
{ id: 'former-colleague', name: 'Former colleague/supervisor' }
],
orientation: 'vertical',
isVisible: () => relationshipsSection.radioButton('hasRelationships')?.value() === 'yes'
});
});
relationshipsSection.addSpacer();
relationshipsSection.addRow(row => {
row.addTextarea('relationshipDetails', {
label: 'Describe each relationship and potential conflict:',
placeholder: "For each relationship: (1) Person's name and relationship to you, (2) Their organization/role, (3) How it may create a conflict",
rows: 4,
autoExpand: true,
isRequired: () => relationshipsSection.radioButton('hasRelationships')?.value() === 'yes',
isVisible: () => relationshipsSection.radioButton('hasRelationships')?.value() === 'yes'
});
});
// ============================================
// SECTION 4: Outside Activities
// ============================================
const outsideSection = form.addSubform('outside', {
title: 'Outside Activities & Employment',
customStyles: () => {
if (outsideSection.radioButton('hasOutsideActivities')?.value() === 'yes') {
return { backgroundColor: '#fef3c7', padding: '16px', borderRadius: '8px' };
}
return { padding: '16px', borderRadius: '8px', border: '1px dashed #e5e7eb' };
}
});
outsideSection.addRow(row => {
row.addRadioButton('hasOutsideActivities', {
label: 'Do you have any outside employment, business activities, or board positions?',
options: [
{ id: 'no', name: 'No outside activities to disclose' },
{ id: 'yes', name: 'Yes, I have outside activities to disclose' }
],
orientation: 'vertical',
isRequired: true
});
});
outsideSection.addRow(row => {
row.addCheckboxList('activityTypes', {
label: 'Select all that apply:',
options: [
{ id: 'employment', name: 'Part-time or secondary employment' },
{ id: 'self-employed', name: 'Self-employment or freelancing' },
{ id: 'consulting', name: 'Consulting work' },
{ id: 'board-membership', name: 'Board/Committee membership (other orgs)' },
{ id: 'nonprofit', name: 'Non-profit volunteer leadership' },
{ id: 'teaching', name: 'Teaching or training' },
{ id: 'speaking', name: 'Paid speaking engagements' }
],
orientation: 'vertical',
isVisible: () => outsideSection.radioButton('hasOutsideActivities')?.value() === 'yes'
});
});
outsideSection.addSpacer();
outsideSection.addRow(row => {
row.addTextarea('activityDetails', {
label: 'Describe each outside activity:',
placeholder: 'For each activity: (1) Organization name, (2) Your role, (3) Time commitment, (4) Any overlap with your responsibilities here',
rows: 4,
autoExpand: true,
isRequired: () => outsideSection.radioButton('hasOutsideActivities')?.value() === 'yes',
isVisible: () => outsideSection.radioButton('hasOutsideActivities')?.value() === 'yes'
});
});
// ============================================
// SECTION 5: Gifts & Entertainment
// ============================================
const giftsSection = form.addSubform('gifts', {
title: 'Gifts & Entertainment',
customStyles: () => {
if (giftsSection.radioButton('receivedGifts')?.value() === 'yes') {
return { backgroundColor: '#fef3c7', padding: '16px', borderRadius: '8px' };
}
return { padding: '16px', borderRadius: '8px', border: '1px dashed #e5e7eb' };
}
});
giftsSection.addRow(row => {
row.addRadioButton('receivedGifts', {
label: 'Have you received gifts, meals, travel, or entertainment from vendors, contractors, or others doing business with us (valued over $50)?',
options: [
{ id: 'no', name: 'No gifts to disclose' },
{ id: 'yes', name: 'Yes, I have received gifts to disclose' }
],
orientation: 'vertical',
isRequired: true
});
});
giftsSection.addSpacer();
giftsSection.addRow(row => {
row.addTextarea('giftDetails', {
label: 'List all gifts, meals, travel, or entertainment received:',
placeholder: 'For each item: (1) Description, (2) Approximate value, (3) Who provided it, (4) Date received',
rows: 3,
autoExpand: true,
isRequired: () => giftsSection.radioButton('receivedGifts')?.value() === 'yes',
isVisible: () => giftsSection.radioButton('receivedGifts')?.value() === 'yes'
});
});
// ============================================
// SECTION 6: Mitigation Plan (if conflicts exist)
// ============================================
const mitigationSection = form.addSubform('mitigation', {
title: 'Conflict Mitigation',
isVisible: () => hasAnyConflicts(),
customStyles: {
backgroundColor: '#eff6ff',
padding: '16px',
borderRadius: '8px'
}
});
mitigationSection.addRow(row => {
row.addTextPanel('mitigationInstructions', {
computedValue: () => 'Since you have disclosed potential conflicts, please describe how you plan to manage or mitigate them.',
customStyles: {
backgroundColor: '#dbeafe',
padding: '12px 16px',
borderRadius: '8px',
borderLeft: '4px solid #3b82f6',
fontSize: '14px'
}
});
});
mitigationSection.addRow(row => {
row.addCheckboxList('mitigationMethods', {
label: 'What mitigation steps will you take? (Select all that apply)',
options: [
{ id: 'recusal', name: 'Recuse myself from related decisions' },
{ id: 'disclosure', name: 'Disclose conflict before discussions' },
{ id: 'supervision', name: 'Ensure oversight by uninvolved party' },
{ id: 'divest', name: 'Divest financial interest' },
{ id: 'resign', name: 'Resign from outside position' },
{ id: 'other', name: 'Other mitigation steps' }
],
orientation: 'vertical'
});
});
mitigationSection.addSpacer();
mitigationSection.addRow(row => {
row.addTextarea('mitigationPlan', {
label: 'Describe your specific mitigation plan:',
placeholder: 'Explain in detail how you will prevent conflicts from affecting your judgment or decisions...',
rows: 3,
autoExpand: true,
isRequired: true
});
});
// ============================================
// SECTION 7: Certification
// ============================================
const certificationSection = form.addSubform('certification', {
title: 'Certification & Acknowledgment',
customStyles: {
backgroundColor: '#f8fafc',
padding: '16px',
borderRadius: '8px',
border: '2px solid #1e293b'
}
});
certificationSection.addRow(row => {
row.addTextPanel('policyText', {
computedValue: () => 'By submitting this disclosure, I acknowledge that:\n\n• I have read and understand the organization\'s Conflict of Interest Policy\n• The information provided is complete and accurate to the best of my knowledge\n• I will promptly update this disclosure if circumstances change\n• Failure to disclose conflicts may result in disciplinary action',
customStyles: {
backgroundColor: '#f1f5f9',
padding: '16px',
borderRadius: '8px',
whiteSpace: 'pre-wrap',
fontSize: '14px'
}
});
});
certificationSection.addRow(row => {
row.addCheckbox('certifyAccurate', {
label: 'I certify that all information provided in this disclosure is true and accurate',
isRequired: true
});
});
certificationSection.addRow(row => {
row.addCheckbox('certifyComplete', {
label: 'I certify that I have disclosed all potential conflicts of interest known to me',
isRequired: true
});
});
certificationSection.addRow(row => {
row.addCheckbox('certifyPolicy', {
label: 'I have read and agree to comply with the Conflict of Interest Policy',
isRequired: true
});
});
certificationSection.addRow(row => {
row.addTextbox('signature', {
label: 'Electronic Signature (Type your full name)',
placeholder: 'Type your full legal name as signature',
isRequired: true
}, '1fr');
row.addDatepicker('signatureDate', {
label: 'Date',
isRequired: true
}, '200px');
});
// ============================================
// SECTION 8: Summary
// ============================================
const summarySection = form.addSubform('summary', {
title: 'Disclosure Summary',
isVisible: () => certificationSection.checkbox('certifyAccurate')?.value() === true
});
summarySection.addRow(row => {
row.addTextPanel('summaryContent', {
computedValue: () => {
const name = employeeSection.textbox('fullName')?.value();
const role = employeeSection.dropdown('role')?.value();
const department = employeeSection.textbox('department')?.value();
const period = employeeSection.dropdown('disclosurePeriod')?.value();
const hasFinancial = financialSection.radioButton('hasFinancialInterests')?.value() === 'yes';
const hasRelationships = relationshipsSection.radioButton('hasRelationships')?.value() === 'yes';
const hasOutside = outsideSection.radioButton('hasOutsideActivities')?.value() === 'yes';
const hasGifts = giftsSection.radioButton('receivedGifts')?.value() === 'yes';
const roleLabels: Record<string, string> = {
'employee': 'Employee',
'manager': 'Manager',
'executive': 'Executive',
'board': 'Board Member',
'contractor': 'Contractor'
};
let summary = `COI Disclosure Summary\n`;
summary += `${'═'.repeat(24)}\n\n`;
if (name) summary += `Name: ${name}\n`;
if (role) summary += `Role: ${roleLabels[role] || role}\n`;
if (department) summary += `Dept: ${department}\n`;
if (period) summary += `Period: FY ${period}\n`;
summary += `\n─── Disclosures ───\n`;
summary += `Financial: ${hasFinancial ? 'Yes' : 'None'}\n`;
summary += `Relationships: ${hasRelationships ? 'Yes' : 'None'}\n`;
summary += `Outside Activities: ${hasOutside ? 'Yes' : 'None'}\n`;
summary += `Gifts Received: ${hasGifts ? 'Yes' : 'None'}\n`;
if (hasAnyConflicts()) {
summary += `\n⚠️ Conflicts disclosed - Mitigation required`;
} else {
summary += `\n✓ No conflicts disclosed`;
}
return summary;
},
customStyles: () => {
const baseStyles = {
padding: '16px',
borderRadius: '8px',
whiteSpace: 'pre-wrap',
fontFamily: 'monospace',
fontSize: '14px'
};
if (hasAnyConflicts()) {
return { ...baseStyles, backgroundColor: '#fef3c7', borderLeft: '4px solid #f59e0b' };
}
return { ...baseStyles, backgroundColor: '#d1fae5', borderLeft: '4px solid #10b981' };
}
});
});
// ============================================
// FORM CONFIGURATION
// ============================================
form.configureSubmitButton({
label: 'Submit Disclosure',
isVisible: () => {
const allChecked =
certificationSection.checkbox('certifyAccurate')?.value() === true &&
certificationSection.checkbox('certifyComplete')?.value() === true &&
certificationSection.checkbox('certifyPolicy')?.value() === true;
return allChecked;
}
});
form.configureCompletionScreen({
type: 'text',
title: 'Disclosure Submitted',
message: () => {
if (hasAnyConflicts()) {
return 'Your conflict of interest disclosure has been submitted for review. Given the conflicts disclosed, a member of the Ethics Committee or HR will contact you within 5 business days to discuss your mitigation plan. Please retain a copy of this disclosure for your records.';
}
return 'Your conflict of interest disclosure has been submitted. No conflicts were identified. A confirmation will be sent to you via email. Thank you for maintaining transparency and ethical standards.';
}
});
}
Frequently Asked Questions
Who should complete this disclosure form?
Typically, all employees, board members, officers, key decision-makers, and contractors with significant authority should complete annual conflict of interest disclosures. Your organization's policy should specify who is required to disclose.
How often should disclosures be updated?
Most organizations require annual disclosures, typically at the start of the fiscal year or employment anniversary. Employees should also update disclosures when new conflicts arise during the year.
What happens after I submit a disclosure?
Disclosures are typically reviewed by HR, Legal, or an Ethics Committee. If a conflict is identified, the reviewer will work with you to develop a mitigation plan. Having a conflict doesn't mean wrongdoing—it means you're being transparent.
What if I'm not sure if something is a conflict?
When in doubt, disclose. It's better to disclose something that turns out not to be a conflict than to fail to disclose an actual conflict. The review process will determine if action is needed.
Are disclosures confidential?
Conflict of interest disclosures are typically treated as confidential and shared only with those who need to review them (HR, Legal, Ethics Committee). Specific policies vary by organization.
Can I customize this for board members vs. employees?
Yes. The form includes role-based questions that can be customized. Board members may have additional disclosure requirements around fiduciary duties and governance matters.