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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.

Individuals are required to file this disclosure with the State Board of Accounts (SBOA) using this form 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 uploads for content. It is the responsibility of the individual reporting the conflict of interest to verify that the document that was submitted is correct and complete.

Upload Disclosure Form


Enter the name of the individual required to disclose a conflict of interest:
Enter the email address of individual required to file this disclosure:


Select name of the Government Entity:

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Select the file to upload (PDF):

 
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