Conflict of Interest Disclosure Statement Upload Tool

The legal requirement for filing disclosures of conflict of interest can be found in the Indiana Code in Title 35 Section 44.1-1-4 (IC 35-44.1-1-4) available at http://iga.in.gov/legislative/laws/2014/ic/titles/035/articles/44.1/ If you have any questions regarding this law or disclosure, you should contact your attorney for legal advice.

Persons required to file this disclosure with the State Board of Accounts (SBOA) can use the form available at https://forms.in.gov/Download.aspx?id=8264. Once you have filled out the form, scan it as a pdf and upload using the tool below. If the Conflict of Interest is on multiple pages, all pages must be in one file, in order and in the correct orientation so that it is readable.

NOTE: The filename should be formatted with only one period before the extension (ex. .pdf, .tif, .jpg). Neither IBRC nor SBOA review the documents for content. It is the responsibility of the user to verify that the document that was submitted is correct and complete.

Upload Disclosure Form

Name of person required to file this disclosure:  
Email address of person required to file this disclosure:  

Government Entity Name:

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Upload PDF:
 

 
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