Conflict of Interest DeclarationΔ Conflict of Interest DeclarationPrima Nota Inc.Full NameRole on CommitteeDateNature of Interest Financial Personal / Relationship Business Interest OtherPlease list any organisations, roles, businesses, or affiliations that may present an actual, potential, or perceived conflict of interest with your role on the Prima Nota Management Committee:Declaration I declare that the information provided is accurate and complete to the best of my knowledge. I have read and understood Prima Nota’s Conflict of Interest Policy and undertake to notify the Secretary if any changes to this declaration occur during my term.SignatureSubmit Declaration
