Fillable Conflict of Financial Interest Disclosure Form (New Mexico Institute of Mining & Technology)

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Conflict of Financial Interest Disclosure Form (New Mexico Institute of Mining & Technology)

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The Conflict of Financial Interest Disclosure Form (New Mexico Institute of Mining & Technology) form is 1 page long and contains:

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  • 2 check-boxes
  • 7 other fields

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File type: PDF

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Conflict of Financial Interest Disclosure Form
Proposal Title:
Agency to which proposal is being submitted:
Principal Investigator (PI):
Dept:
Phone:
Email:
I have read the Conflict of Interest Policy
(https://www.nmt.edu/research/docs/policies/ConflictOfInterestPolicy.pdf) enacted by the New
Mexico Institute of Mining and Technology, and hereby state that: (check one)
I have no significant financial interests to disclose related to the proposed research at this
time. I will file a new Conflict of Financial Interest Disclosure Form if any change occurs
during the contract period.
I have the following significant financial interests to disclose which may be related to
the proposed research:
PI Signature: Date:
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Conflict of Financial Interest Disclosure Form (New Mexico Institute of Mining & Technology)

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Completed 24 August 2020

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