R-03 — Conflict declaration
Purpose: Record interests that could affect impartial work.

Project:

Person and role:

Financial interests:

Relationships and prior advocacy:

Public statements or litigation:

Proposed mitigation:

Recusal decision and approver:

COMPLETION CHECKS
[ ] Update when circumstances change
[ ] Disclosure does not automatically cure a conflict
[ ] Use an independent decision-maker

Prepared by:
Date:
Version:
Reviewer / approval:

Blank template. Keep completed records in the approved channel. This template does not grant authority.