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CONFUcTOF IN1tREST POLICY FOR NON STAFF
Annex II
Declaration of Interests. (Dol)
FlrstName
Surname
Authority!
MS
YA 4’b\I jsi
NK qP N
EBA
L_o (4)
Iflvoivernent
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I declare that I have read the Decision of the Management Board on Conflict
of Interest Policy (EBA DC 2014 103) and that this declaration is truthful and
carnpiete
I do hereby declare on my honour that
JzI
%
Date:
to the
best of my knowledge, the
Conflict of Interest as defined in Article I(2)(c) of
the Policy in respect of my activities which fall under the EBA’s scope of
action are thoselisted in the annex..
only interests that create a
Whenever I have a Conflict of Interest I will alert the EBA
Signature:
7/ol/Loic
P1ea send a signed copy afthisforrn to the Eai’s Ethir$ Officer [email protected]
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CONFUCT OF INTERESTPOLJCY FOR NON STAFF
Annex to Dedarations of interests
In all cases, please provide as many details as possible (in the case ofo body or employer, full
name, location, private or public nature and your role).
Nature of conflict
Period
(from /tlII)
1.
Economic
Interest
1.
2.
II.
Membership
III.
Employment
or
Consultancy
1.
2.
1.
2.
IV.
Intellectual
Property
Rights
1.
2.
V.
Other
1.
VI.
Interests of :ie÷
close family
members
S-..
Organisation
2.
(,
EarUj
ut ‘
.
-
Subject matter/ Reasons why
my
independence may be
impaired
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t
O&fet(eA reø.wieacion -fosY
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