Research Corporation of the University of Hawaiʻi

Research Corporation
of the University of Hawai‘i
Human Resources Department
EMPLOYMENT OF RELATIVES & OTHER CLOSE RELATIONSHIPS FORM
This form identifies a close relationship between the individuals identified below:
___________________________________ Employee Name
___________________________________ Relative/Close Relationship Name
_________________________________ Position Title
_________________________________ Position Title
Relative/Close Relationship Status: __________________________________________________
Is there a Supervisory Relationship: Yes
Direct Supervisor’s Information of the Employee:
______________________________________ Supervisor’s Name
No
Contact Information (email, phone number): ____________________________________________
Please Read Carefully and Sign:
In accordance with the RCUH policy on the Employment of Relatives & Other Close Relationship, I ensure that the above relationship shall not inhibit or adversely affect the fair and equitable treatment of the other employees of the project. Evaluation of performance and professional competence shall be carried out objectively and fairly through committees and outside review as appropriate. Further, in the event of a supervisor-subordinate relationship between the above relatives, the supervisor shall disqualify himself/herself from all deliberations and actions affecting economic benefits to his/her relative and other actions where appropriate.
Acknowledged & Confirmed by:
______________________________________________ ________________ Principal Investigator/Authorized Designee’s Signature Date
______________________________________________ Principal Investigator/Authorized Designee’s Name
______________________________________________ ________________ Employee’s Signature Date
______________________________________________ ________________ Relative/Close Relationship’s Signature Date
Approved/Not Approved:
______________________________________ _______________ Director of Human Resources or Designee Date
RCUH Form E-6
Created 04/29/97 (Revised 10/08/07, 03/07/11, 11/02/13, 03/25/14, 02/08/16)
___________________________ Title