ࡱ> (*'a L bjbj .hGbhGbL    -//////$\SSh--@Pd/ ~0$SS B b: Disclosure of Financial Interest Form I have read and will abide by the ý of Chicago Conflicts of Interest in Research policy. Significant financial interests, as defined in the Conflicts of Interest in Research policy, are disclosed below. I agree to comply with the restrictions imposed by the university in managing, reducing or eliminating conflicts of interest. I will provide updated financial disclosure annually and, to disclose any significant change in the financial holdings of myself, spouse or dependent children to the Associate Provost for Research. Signature: ______________________________ Printed Name: ______________________________ Date: ____________________ The significant financial interests held by myself, spouse and dependent children are as follows: (Attach additional pages as needed) &\_K L hE%PhqOJQJ^JhE%POJQJ^JhE%P5CJOJQJ^JaJ&'(J K L w x ' K L $a$,1h/ =!"#$% s2&6FVfv2(&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA D Default Paragraph FontViV  Table Normal :V 44 la (k (No List PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vc:E3v@P~Ds |w< LL L 8@0(  B S  ?_fNN\_KN\_NqE%PSLN@____L@UnknownG.[x Times New Roman5Symbol3. .[x ArialACambria Math"hjF}}!r4KK3QHP ?S2!xxhU %Disclosure of Financial Interest FormHai WuRios, Jennifer Oh+'0 (4 T ` lx(Disclosure of Financial Interest FormHai Wu Normal.dotmRios, Jennifer3Microsoft Office Word@F#@Je@/} ՜.+,0$ hp  ý ChicagoK &Disclosure of Financial Interest Form Title  !"#$%&)Root Entry Fd/+1Table WordDocument.SummaryInformation(DocumentSummaryInformation8CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q