Collective Action Fund Conflict of Interest Disclosure Form

*Conflict of Interest information can only be submitted by individuals related to Tides' Funds' Collective Action Fund Independent Advisory Committees. If you have reached this page without a direct invitation to complete this form, please reach out to your project's director for an invitation to complete this form.

Source

Invited

In order to submit this form you must have a custom link provided to you from your advisor at Tides. Please reach out to your advisor if you need this information resent to you.

Tides Fund Name

First

Last

COI Details

Conflict of Interest Statement

I have no Conflicts of Interest as defined in the Tides Conflict of Interest Policy to report regarding the fund named aboveIn compliance with the Conflict of Interest Policy, I hereby report the following relationships, interests, or situations involving me or a Related Party (as defined in the Conflict of Interest Policy) that might result in or appear to be an actual, apparent or potential conflict of interest in connection with my duties and responsibilities to Tides

Positions that you or any of your immediate family member (e.g., parents, siblings, spouses and children) has with organizations or businesses that may have a relationship with the Fund:

Relationships that you or any of your immediate family has with known donor(s) to the Fund:

Any other relationships and information that may be relevant to identifying potential conflicts:

My primary business or occupation at this time:

Please note: This form uses an e-signature process. Once you provide your e-signature, you will then receive an email with a link to verify your e-signature. As many email services now pre-click links for security, this may count towards the verification. If you click the link and see an error page with language stating that you "Cannot verify signatory for a completed e-signature record", this means it's already been verified and successfully submitted.