Environmental Research Project

Researcher Name Project Title Institution / Organization Date

1. Financial Interests

Do you have any financial interests related to this project? (e.g. grants, contracts, equity, patents, honoraria, etc.)

2. Personal Relationships

Do you have personal relationships that may affect, or appear to affect, your impartiality?

3. Organizational Affiliations

Do you hold any positions or roles in organizations that may be relevant to this research?

4. Other Potential Conflicts

Are there any other potential conflicts of interest to declare?

5. Declaration

I hereby declare that the above information is accurate and complete.