Research Corporation of the University of Hawaiʻi

Annual Declaration of
Receipt of Gifts and Gratuities
Compliance with Standards of Conduct

In accordance with the Anti-Kickback Act of 1986 (41 U.S.C. 51-58), I hereby declare that I have not received any money, fee, commission, credit, gift or gratuity, thing of value, or compensation of any kind from any contractor. I further declare that I have complied with the Standards of Conduct as contained in RCUH Policies and Procedures, Section 2.004.

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Signature Date

Print Name ____________________________________

Department ____________________________________