ARF Duality of Interest Disclosure Form

Conflicts of interest relate to the potential for self-gain usually, but not always, financial. A potential conflict of interest exists for an ARF Board member when commitments and obligations to the board or to recognized professional norms could be compromised by a person's other interests or commitments, especially financial. Equities and positions of members of the immediate family which could create a conflict of interest between the obligations of an ARF Board member and those outside interests must also be disclosed.

1. Do you or any immediate member of your family serve in any advisory or decision making capacity for any organization which conducts research relative to alpacas? If yes, explain.
2. Do you or any immediate member of your family have a financial interest in alpacas or an alpaca related business? If yes please give name of business and location.
3. Do you have any other commitments, which might interfere with your ability to perform the duties of an ARF board member? If yes, explain.

I understand that if at any time there is a matter under consideration, which may constitute a direct or indirect conflict of interest for me, it is my obligation to disclose the facts surrounding the possible conflict to the board, to withdraw from the meeting if requested by a majority of the board, and to refrain from voting on matters in which a conflict may exist.

Date________________ Signature_________________________________