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Declaration of Conflict of Interest

AGREEMENT, made on (... date of declaration ...) by and between (... name of Employer ...) (... address of Employer ...) (hereinafter referred to as the "Company"), (... name of Employee ...) (... address of Employee ...) (hereinafter referred to as the "Employee").

01. Employee acknowledges that he/she have read the Company policy statement concerning conflicts of interest, and do hereby declare that neither he/she, nor any member of their immediate family, and/or any other business to which they may be associated with, do have any conflict of interests, and that the proper performance of their responsibilities to the Company would be carried out to the very best of their ability.

02. Employee further acknowledges that any deviation would constitute a violation of Company policy. Furthermore, the undersigned does hereby declare that during their employment, they shall continue to maintain all affairs in accordance with the requirements of said company policy..

4. No Harassment. Both parties agree not to molest, harass, interfere with, or impose any restraint upon the other, except as set out in this declaration.

5. Representations. Each party acknowledges that this declaration has been entered into of his or her volition with full knowledge and information including tax consequences. In some instances, it represented a compromise of disputed issues. Each believes the terms and conditions to be fair and reasonable under the circumstances. No coercion or undue influence has been used by or against either party in making this declaration. Each party acknowledges that no representations of any kind have been made to him or her as an inducement to enter into this declaration other than the representations set forth herein.

[Alternative Paragraph]

05. Representations. Neither party has made any representations nor promises, other than those contained in this declaration or in some further writing signed by the party making the representation or promise.

06. Modifications. A modification or waiver of any of the provisions of this declaration shall be effective only if made in writing and executed with the same formality as this declaration. Failure of either party to insist upon strict performance of any of the provisions of this declaration shall not be construed as a waiver of any subsequent default of the same or similar nature.

08. Number and Gender. Whenever the singular number is used in this Declaration and when required by the context, the same shall include the plural. The masculine gender shall include the feminine and neuter genders, and the word "person" shall include a corporation, firm, partnership, or other form of association.

09. Termination of Declaration. This declaration may be terminated at any time by the parties written declaration. We agree that from time to time an amendment of this declaration may be desirable and we therefore agree that said amendment may be accomplished by written amendment only.

10. Miscellaneous Provisions. The various headings and numbers herein and the grouping of provisions of this Declaration into separate divisions are for the purpose of convenience only and shall not be considered a part hereof. The language in all parts of this Declaration shall in all cases be construed in accordance to its fair meaning as if prepared by all parties to the Declaration and not strictly for or against any of the parties.

11. Assignment. This Declaration is of a personal nature and may not be assigned.

12. Complete Declaration of the Parties. This is the complete declaration of the parties and it supersedes any declaration that has been made prior to this declaration.

13. Governing Law. The parties hereby expressly acknowledge and agree that this Declaration is entered into in the State of [STATE] and, to the extent permitted by law, this Declaration shall be construed, and enforced in accordance with the laws of the State of [STATE].

14. IN WITNESS WHEREOF, the parties have signed this Declaration on the date first above written.

By: [signature]

Employer

[signature]

Employee