Proposal Transmittal Log #__________________  Date_________________________________

Name __________________________________ Title _____________________________________

Department ______________________________ College/Unit ____________________________

Department Chair (Initial Review Authority)________________________________________

Sponsoring Agency _________________________________________________________________

Project Title _____________________________________________________________________

____	I certify that I have read and understand the NDSU SPONSORED PROJECT FINANCIAL
DISCLOSURE POLICY (Section 823 of NDSU Policy Manual).

____	I hereby disclose Significant Financial Interests which may be related to a 
sponsored project to be funded by the above named agency.  An explanation identifying 
the Significant Financial Interests involved, their nature and amount, is provided below.

____ 	I understand that I am required to update this disclosure as these financial 
interests change throughout the duration of the sponsored project.














Investigator Signature_________________________________ Date_______________________

____	I certify that I have read and understand the NDSU SPONSORED PROJECT 
FINANCIAL DISCLOSURE POLICY (Section 823 of NDSU Policy Manual).

____	I have reviewed the information provided above and, in consultation with the 
Investigator, have determined that Significant Financial Interests do exist.   
An explanation is provided below.

____	I have reviewed the information provided above and, in consultation with the 
Investigator, have determined that Significant Financial Interests do not exist.  
An explanation is provided below.










Initial Review Authority Signature__________________________ Date ______________