Conflict of Interest Declaration Form - Template Form Pro · NG-law

________ (the "Company")

RC No.: ________

Registered Office: ________

CONFLICT OF INTEREST DECLARATION FORM

This Declaration is made pursuant to the duties of fidelity and good faith owed by every employee to the Company, the fiduciary duties imposed under the Companies and Allied Matters Act 2020, and the Company's internal codes of conduct and conflict of interest policies.

§ 1 — PARTICULARS OF THE EMPLOYEE

Name of employee: ________

Job title/position: ________

Department/Unit: ________

Employee/Staff identification number: ________

Residential address: ________

Email: ________

Phone: ________

§ 2 — DECLARATION AND UNDERTAKINGS

I, ________, of ________, do solemnly and sincerely declare and undertake as follows:

1. That I do not, save as expressly disclosed in § 3 below, have any actual, potential, financial, or other personal interest in any matter relating to my position in the Company which may affect, or be perceived to affect, my commitment, loyalty, objectivity, or judgement in the discharge of my duties.
2. That I shall not engage in any transaction, arrangement, or activity that gives rise to, or may reasonably be perceived to give rise to, a conflict between my personal interests and the interests of the Company.
3. That I shall not be involved in the recruitment, promotion, appraisal, appointment, supervision, or remuneration of any close relative or person with whom I have a personal, family, or financial relationship, without first disclosing such relationship to management in writing.
4. That I shall not engage in any transaction, dealing, or activity that conflicts with the interests, objectives, or lawful directions of the Company.
5. That I shall not use, disclose, or misappropriate the Company's confidential information, trade secrets, intellectual property, or proprietary information for personal gain or for the benefit of any third party, and that I shall at all times comply with my obligations under the Nigeria Data Protection Act 2023 in respect of personal data to which I have access.
6. That I shall not own, operate, manage, advise, or otherwise be involved in any business or undertaking that directly or indirectly competes with the business of the Company, save with the prior written consent of the Company.
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8. That I shall not allow my actions, decisions, or interests in the course of my duties to be improperly influenced by any personal gain or benefit.
9. That I shall avoid any future transaction, dealing, or relationship that may prejudice my fiduciary duties, duty of fidelity, or commitment to the Company.

§ 3 — DISCLOSURE OF ACTUAL OR POTENTIAL CONFLICT

Notwithstanding the foregoing declaration, and in the interest of full and frank disclosure, I hereby disclose the following actual, potential, or perceived conflict(s) of interest (if none, state "NIL"):

________

§ 4 — CONTINUING OBLIGATION

I undertake to promptly disclose to the Company, in writing and without delay, any actual, potential, or perceived conflict of interest that may arise after the date of this Declaration, and to update this Declaration as and when required by the Company.

§ 5 — GOVERNING LAW

This Declaration shall be governed by and construed in accordance with the laws of the Federal Republic of Nigeria.

ACKNOWLEDGEMENT

I acknowledge that I have carefully read and understood this form and I confirm that the information provided herein is true, correct, and complete to the best of my knowledge and belief.

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SIGNED, DECLARED, AND ACKNOWLEDGED by the Employee:

Name of Employee: ________

Signature of Employee: ________

Date: ________

RECEIPT AND ACKNOWLEDGEMENT BY THE COMPANY

Received on behalf of the Company by:

Name: ________

Designation: ________

Signature: ________

Date of Receipt: ________