Conflict of Interest Form

SID EXCOM MEMBER - 2021 1 E 85 40 Model Statement of Acceptance THIS DECLARATION applies, to the best of my knowledge, to all members of my immediate family (spouse, children, parents) and its provisions shall protect any organization affiliated with or subsidiary to the Southern Africa-Indian Ocean Division of the General Conference of Seventh-day Adventists. In the event facts change in the future that may create a potential conflict of interest, I agree to notify the Southern Africa-Indian Ocean Division of the General Conference of Seventh-day Adventists in writing. 1. I have read the Statement of Ethical Foundations and the policy on Conflict of Interest and/or Commitment. 2. I am in compliance with my employer’s policy on Conflict of Interest and/or Commitment as printed above. 3. Except as disclosed below: a. Neither I nor my family have a financial interest or business relationship which competes with or conflicts with the interests of the Southern Africa-Indian Ocean Division of the General Conference of Seventh-day Adventists. b. Neither I nor my family have a financial interest in nor am or have been an employee, officer, director, or trustee of, nor receive/have received financial benefits either directly or indirectly from any enterprise (excluding less than five percent [5%] ownership in any entity with publicly traded securities) which is or has been doing business with or is a competitor of the Southern Africa-Indian Ocean Division of the General Conference of Seventh-day Adventists. c. Neither I nor my family receive/received any payments or gifts (other than of token value) from other denominational entities, suppliers, or agencies doing business with the Southern Africa-Indian Ocean Division of the General Conference of Seventh-day Adventists. d. Neither I nor my family serve/have served as an officer, director, trustee, or agent of any organization affiliated with or subsidiary to the Southern Africa-Indian Ocean Division of the General Conference of Seventh-day Adventists in any decision-making process involving financial or legal interests adverse to the Southern Africa-Indian Ocean Division of the General Conference of Seventh-day Adventists.