APPLICATION

About the presence (absence) of a conflict of interest in the process of filling out the annual declaration of an employee working at Samarkand State University

Full name:

 

 

 

Structural division of SamSU:

 

 

Position:

 

Full name of the immediate supervisor and position

 
 

The following terms are used in this application:

close relatives - persons related by blood, i.e. parents, biological and step-brothers and sisters, spouse, children, including adopted children, grandparents, grandchildren, as well as parents, biological and step-brothers and sisters of the spouse ;

related persons - persons participating in the authorized capital of commercial organizations with the employee, except for the cases where they own less than five percent of the shares of joint stock companies whose shares are in public circulation on the Republican Stock Exchange;

conflict of interest - a situation in which personal (direct or indirect) interest affects or may affect the proper performance of the Ministry's official duties, and a conflict between personal interest and the rights and legal interests of the Ministry occurs or may occur;

employee's personal interest - in the form of money, tangible or intangible values, other property, wealth and privileges, which may affect the employee's proper performance of his or her official duties or service obligations by his close relative or persons related to the employee during the performance of his official duties. opportunity for personal gain (personal, social, financial, political and other commercial or non-commercial interests).

Т/р

Questions for filling the declarance

1.

Are you considered an employee, member of the governing body (supervisory board, board of directors, etc.), director or representative of an organization? When answering, please consider the following, regardless of the organizational and legal form and form of ownership, do you have a share in commercial and non-commercial organizations, and do you receive any form of compensation from these organizations?

 (Note: Mark yes or no. If yes, write the name of the organization and your position in it)

 

Yes/No

 

Comment:

2.

Do you or your close relative have any financial interest in any organization (including participation in the authorized capital, ownership of stocks and bonds) or can you otherwise influence decision-making in such organizations? (do you own non-public shares of any organization, or do you have a share in the authorized capital, or do you own 5% or more of the public securities of any organization on the Republican Stock Exchange or other stock exchanges?)

 (Note: please check "yes" or "no". If "yes", please indicate in the "Comment" section the names of all relevant organizations and the appearance of your interest in them (participation in the share capital, ownership of shares, etc.) .

 

Yes/No

 

Comment:

3.

Do your close relatives (persons related to you) work in the central office of the ministry, its regional departments or subordinate centers or educational institutions?

 (Note: Mark the answer "yes" or "no". If your answer is "yes", in the "Comment" section, clearly write the name, position and name of the department/department/department where he/she is working.

 

Yes/No

 

Comment:

4.

Do your close relatives, their children, or persons related to you, their children study in higher, secondary-special or professional educational institutions under the jurisdiction of the Ministry of Higher Education, Science and Innovation?

(Note: select the answer "yes" or "no". If your answer is "yes", write down the name of such relative and the educational institution he is studying in the "Comment" section)

 

Yes/No

 

Comment:

5.

5. Are your close relatives an employee, member of the management body (supervisory board, board of directors, etc.), director or representative of any organization? When answering, please consider the following, regardless of organizational and legal form and form of ownership, does it have a share in commercial and non-commercial organizations, and does it receive any form of compensation from these organizations?

 

 (Note: mark the answer "yes" or "no". If your answer is "yes", indicate the name of the organization where your close relative works and the position in it in the "Comment" section)

 

Yes/No

 

Comment:

6.

Are any of your close relatives government officials?

 (Note: mark the answer "yes" or "no". If your answer is "yes", write the name, position and name of the organization of your close relative in the "Comment" section)

 

Yes/No

 

Comment:

7.

Are there persons related to you participating in the charter capital of commercial organizations together with you, except for cases where the total amount of shares of joint stock companies freely traded on the Republican Stock Exchange or other stock exchanges is less than five percent.

(Note: select the answer "yes" or "no". If your answer is "yes", in the "Comment" section, indicate the name of the persons related to you, the names of all relevant organizations, participation in the authorized capital and share ownership)

 

Yes/No

 

Comment:

8

Have you received money or other material assets, gifts, or services that could be interpreted as illegal or unethical to influence decisions in the course of performing your duties?

(Note: Select yes or no. If yes, please elaborate in the Comment section)

 

Yes/No

 

Comment:

9

Have you used your official position for your personal interests or for the interests of your close relatives (persons related to you)?

(Note: Mark yes or no. If yes, please elaborate in the Comment section)

 

Yes/No

 

Comment:

10

During your work in the university system, have you used confidential information related to the university system known to you for your personal benefit, your close relatives or the interests of persons related to you (including disclosure to legal entities or individuals)?

(Note: Mark yes or no. If yes, please elaborate in the Comment section)

 

Yes/No

 

Comment:

11

Are you aware of violations of the Ministry's internal regulations on anti-corruption and ethics issues by employees of the university system?

(Note: Mark yes or no. If yes, please elaborate in the Comment section)

 

Yes/No

 

Comment:

12

If there are other situations that lead to a conflict of interest, indicate them.

 

Comment:

13

Specify any other additional information you deem necessary.

 

Comment:
  •  
  •  
  •  
  • By signing this application, I also certify that:
  • I got acquainted with the Regulation on combating corruption in the system of the Ministry of Higher Education, Science and Innovation, anti-corruption and ethics rules of the employees of the system of the Ministry of Higher Education, Science and Innovation, and the Regulation on managing conflicts of interest in the system of the Ministry of Higher Education, Science and Innovation;
  • during the indicated period, I have been following the requirements and principles established by the internal documents of the Ministry of Higher Education, Science and Innovation;
  • I have/don't have situations leading to a conflict of interest; (underline the correct one);
  • I guarantee the completeness and correctness of the information provided in this application and I agree that the application will be checked by the relevant department of the Ministry of Higher Education, Science and Innovation;
  • I will immediately notify the appropriate department of the ministry in accordance with the requirements of the Regulation on the management of conflicts of interest in the system of the Ministry of Higher Education, Science and Innovation about new cases that become known to me, except for the application filled out by me

 

_________________________________________________________________________          

(Full name)

 

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                 (date)                                                                                       (signature)