Annex B: conflict of interest and life factors form (accessible)
Published 17 August 2026
© Crown copyright 2026
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This publication is available at https://www.gov.uk/government/publications/management-of-counter-corruption/annex-b-conflict-of-interest-and-life-factors-form-accessible
Contracted Service Providers staff may occasionally face personal or professional circumstances that could affect their ability to remain resilient to corruption. To manage these risks, it is essential to declare any private interests that may interfere with official duties or compromise integrity.
This must be done by completing the Conflict of Interest and Life Factors Form:
When to complete:
- At the start of employment
- Annually thereafter, even if there are no changes to declare
- Immediately upon any change in circumstances (do not wait for the annual review)
Purpose:
Submitting this form is a safeguard, not an admission of wrongdoing or corruption, and will not be regarded as such; rather, it upholds the Civil Service values of integrity, honesty, objectivity, and impartiality.
Submission:
Updated forms must be submitted to your local Counter Corruption team.
Retention:
The CSP must ensure that conflict of interest declarations and registers are retained securely for a minimum of five (5) years after the staff member leaves employment
Required Information
Staff Member’s Details
Full name:
DoB:
Role:
Location:
Employer:
Contact Details:
| Business interests (including secondary employment) | Yes/No |
| Financial difficulties (Including bankruptcy, insolvency, individual voluntary arrangements (IVAs), CCJs and any financial account that are put into a default status) | Yes/No |
| A substantial change in financial circumstances (Such as receiving a sizeable inheritance or your financial circumstances having been affected by divorce or dissolution of a civil partnership.) | Yes/No |
| Criminal convictions/police cautions/ or investigations including those where no further action has been taken. | Yes/No |
| Any personal or domestic relationships which could compromise or be perceived to compromise them in the discharge of their duties (for example if you know, have known or have contacted or are in contact with a detained or formerly detained individual. This includes anyone residing within any custodial establishment, outside of work through friends, family or previous employment) | Yes/No |
| Any other domestic or personal circumstances that could have an impact on the working environment. (including disclosure of prescribed use of medical Cannabis) | Yes/No |
Use the below space to explain the conflict of interest or life factor
Signed:
Date:
NB: Failure to report changes in circumstances may lead to your security clearance being void. If your clearance is void, you can no longer work on a Home Office contract or as a DCO.
It is your responsibility to ensure you maintain your certification and security vetting, and to report any changes in circumstances.