Certification Questions

Is there a Financial Conflict of Interest with regard to this proposal due to your financial interest in a vendor or subrecipient connected with this proposal?

  • Explanation: Check Yes if any investigator involved with this proposal has any financial relationship with the sponsor. Examples of financial relationships include (but are not limited to): paid consulting or other paid employment, paid membership on a scientific advisory board, membership on the sponsor's board of directors, ownership of stock or stock options or other forms of equity in the sponsor, receipt of licensing fees from the sponsor as an inventor, or family members having such relationships. Disclosure and exemption of financial conflicts of interest are required for all sponsored research investigators. Failure to disclose financial conflicts of interest may result in significant delays in submitting proposals. Should an award be made, research will be delayed until conflict of interest issues have been resolved. For a more detailed explanation, consult the Conflict of Interest Officer.
  • Policies and regulations: Conflict of Interest

Are you currently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from current transactions by and federal department or agency?

Are you delinquent on any federal debt?

Lobbying activities have been conducted regarding the proposal?

The information contained within the submitted application is true, complete and accurate to the best of my knowledge; I understand that any false, fictitious, or fraudulent statements may subject me to criminal, civil, or administrative penalties; I accept responsibility for the conduct of the project and will provide any required reports if an award is made as a result of this application.

If this is a proposal to a sponsor that follows the PHS Financial Conflict of Interest (FCOI) Policy, have you completed the required training and submitted the required financial disclosures to the UMB Conflict of Interest Officer?