Fillable ANNUAL CERTIFICATION OF COMPLIANCE WITH CONFLICT OF INTEREST (Florida Department of Agriculture and Consumer Services)

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ANNUAL CERTIFICATION OF COMPLIANCE WITH CONFLICT OF INTEREST (Florida Department of Agriculture and Consumer Services)

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BROWSE FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES (FL) FORMS

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CH ___________ DATE _____________
DTN __________
ANNUAL CERTIFICATION OF COMPLIANCE WITH
CONFLICT OF INTEREST POLICY (sample)
Pursuant to s. 496.4055(2), Florida Statutes, ______________________________ has
(Name of Organization/Sponsor)
adopted a policy regarding conflict of interest transactions. All directors, officers, and
trustees of the charitable organization hereby certify compliance with the adopted policy.
NAME SIGNATURE DATE
1. __________________________ ___________________________ ____________
2. __________________________ ___________________________ ____________
3. __________________________ ___________________________ ____________
4. __________________________ ___________________________ ____________
5. __________________________ ___________________________ ___________
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16. __________________________ ___________________________ ____________
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ANNUAL CERTIFICATION OF COMPLIANCE WITH CONFLICT OF INTEREST (Florida Department of Agriculture and Consumer Services)

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Completed 20 July 2020

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