As adopted by the Hepburn Library of Madrid Board of Trustees, December, 2021.

No Board member or Committee member of the Hepburn Library of Madrid shall derive any personal profit or gain, directly or indirectly, by reason of his or her participation on the Board. Other than compensation, no employee shall derive any personal profit or gain, directly or indirectly, by reason of his or her employment by the Hepburn Library of Madrid except through activities that may facilitate professional advancement or contribute to the profession, such as publications and professional service, and which have been fully disclosed to the Board.

Each individual shall disclose to the Board any personal interest which he or she may have in any matter pending before the Board and shall refrain from participation in any decision on such matter.

The existence of any such conflict and the subsequent process shall be documented in the minutes of any meeting in which the conflict was discussed or acted on.

Members of the Hepburn Library of Madrid Board, committees, and staff shall refrain from obtaining any list of library patrons that results in personal benefit.

Statement of Associations

This is to certify that I, except as described on the reverse of this sheet, am not now, nor at any time during the past year, have been:

A participant, directly or indirectly, in any arrangement, agreement, investment, or other activity with any vendor, supplier, or other party doing business with the Hepburn Library of Madrid that has resulted or could result in personal benefit to me.

Any exceptions to the above are stated on the reverse of this sheet with a full description of the transactions, whether direct or indirect, which I have (or have had during the past year) with persons or organizations having transactions with the Hepburn Library of Madrid.


Signature: _______________________________________ Date: ____________________

Printed name: _____________________________________________________________

Hepburn Library of Madrid position (Board, Staff, Committee Member: _________________________________________________________________________

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