CONFLICTS OF INTEREST DECLARATION

NAMED PERSONS UNDER ASPA 1986

It is important that any named person1 responsible for animal welfare under the
Animals (Scientific Procedures) Act 1986 (ASPA) must not be in a position where
he or she does not put his/her over-riding welfare obligations to the animals
first. A person with a controlling financial interest or a substantial interest in the
scientific outcome of a project might be presumed not to be suitable as such a
named person in the absence of compelling circumstances to the contrary. In
order for the Secretary of State to determine whether an individual nominated
to be such a named person is suitable, it is important to be fully aware of any
real or perceived conflicts of interest which exist.

A separate declaration should be completed by each person nominated by an

establishment licence holder to be such a named person and should
accompany the Application for Designation of an Establishment, or the
Application for Change(s), as appropriate.

Full Name:      

Position/      
Establishment:

(Please tick the statement which applies.) Either:

I declare that to the best of my knowledge and belief neither I nor my

spouse, partner, immediate family or close friends have any interests which
might conflict, or be perceived to conflict, with my duties as a named person
responsible for animal welfare. Furthermore, if my situation should change, I
will notify the establishment licence holder without delay.

I declare interests below for consideration and have also set out the action
I am taking to minimise the risk of these interests coming into conflict, or
perceived conflict, with my duties as a named person responsible for animal
welfare. I certify that the information included is, to the best of my
knowledge and belief, accurate and complete. Furthermore, if my situation
should change, I will notify the establishment licence holder without delay.

Signed

Print Name       Date      

1
Named Persons responsible for animal welfare under the Animals (Scientific Procedures) Act 1986
(ASPA) are those appointed as a Named Veterinary Surgeon (NVS) or a Named Animal Care and
Welfare Officer (NACWO).
Directorships and Shareholdings

Please list and briefly describe the following:

 Any directorships and partnerships you hold in companies which may have a
direct or indirect relationship with the establishment;
 Any significant shareholdings in companies which may have a direct or
indirect relationship with the establishment;
 Any other significant shareholdings in companies which may be engaging in
large business transactions with the establishment.

As a guide, “significant” would be any shareholding in a private company or, in a

public company, a shareholding amounting to more than 1%.

     

Research interests

Of the five key roles2 under ASPA, please list all those which you will be fulfilling at
the establishment. It is normally expected that these five roles will be allocated to not
less than three individuals, that the key roles of establishment licence holder, NVS
and NACWO will not be combined in one individual and that, where a named person
has a substantial interest in the scientific outcome of a project, alternative provision
will be made for the care and welfare of the animals.

     

2
Establishment licence holder; Project licence holder, Personal licence holder; Named Veterinary
Surgeon (NVS); Named Animal Care and Welfare Officer (NACWO).
Close relations and friends

Please list any possible conflicts of interests created by virtue of the employment,
directorships, partnerships or significant shareholdings of close relations or close
friends.

     

Any other matters

Please list any other matter which may give rise to a potential conflict of interest e.g.
membership of committees/organising bodies with decision-making or purchasing
powers, beneficial ownership of property, etc.