Policies and Forms
Conflict Avoidance Statement
Refer also to the Conflict of Interest Policy.
Harvard University Conflict Avoidance Statement
Name: [ ]
Department/Faculty: [ ]
Licensed Technology: [ ]
Licensee Company/Address: [ ]
Because of the license granted by Harvard to the above company and my Close Financial Interest in this firm, I acknowledge the potential for a possible conflict of interest between the performance of my research and teaching obligations at Harvard and my personal financial interests as well as my contractual or other obligations to this firm. Therefore, I will not:
involve students or post-doctoral fellows at Harvard in research and development projects for the company without the prior approval of the dean or the dean's designee;
restrict or delay general access to information from Harvard research; and/or
alter the scope or direction of my Harvard research in order to materially benefit the company.
In addition, in order to avoid the appearance of a conflict, I will attempt to differentiate clearly between the intellectual directions of my Harvard research and my contributions to the company. To that end, I will report annually to my department head (and/or faculty supervisor) and to the chairperson of the appropriate Faculty committee the general nature of my activities on behalf of the company and how those differ from my Harvard research.
Finally, I understand that Faculty policy may require me to disclose that I have a financial interest in the company in any publications or public statements I make presenting research results related to this license.
Signature/Date: [ ]
Acknowledged by department head/Date: [ ]
Acknowledged by faculty supervisor(for staff, students and post-docs)/Date: [ ]
Acknowledged by chairperson of Faculty committee (if required)/Date: [ ]
Refer also to the Conflict of Interest Policy.