2026 Conflict of Interest Disclosure

"*" indicates required fields

Name of Discloser*
Email Address for Discloser*
Are you a voting Director*
Are you an ISCD Officer*
If you are an Officer, which Officer Position do you hold:
Are you a Key Employee?*
By checking each box this will serve as your initials that each statement below is true:*
Disclosures:

I have read the Policy attached hereto and attest that the disclosures above are true and complete to the best of my knowledge.

NOTE: This form is to be signed by each Responsible Person upon initial election or appointment and at the end of every calendar year.

Conflict of Interest Policy
By checking this box and typing my name below, I am electronically signing my Conflict of Interest Disclosure Form:*
Date*