Finance Division

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FCOI Public Request Form

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Form for Request of Information about

Investigator Financial Conflicts of Interest associated with PHS Support

In compliance with the Public Health Service (PHS) regulation on Responsibility of Applicants for Promoting Objectivity in Research for which PHS Funding is Sought (42 C.F.R. Part 50, Subpart F), members of the public may request information about financial conflicts of interest (FCOI) associated with principal investigators and senior/key personnel on Public Health Service-supported projects at the �Ӱ�ԭ�� (Scranton). Scranton will respond within five business days of the receipt of the request. Under the regulation, Scranton must provide FCOI information if:

The significant financial interest was disclosed to the �Ӱ�ԭ�� and is still held by the senior/key personnel; and
Scranton determined that the significant financial interest is related to the PHS-funded research; and
Scranton determined that the significant financial interest is a financial conflict of interest (FCOI) under regulatory standards.

Requests must be submitted by completing this form. Each request must list either the name of an investigator or a PHS award number or Project Title. Only one name or award number or project title may be listed on each request. Individuals may submit more than one request. If an investigator’s name is listed, all the required FCOI information for that investigator will be provided. If a PHS award number or project title is listed, all the required FCOI information about that award will be provided. Multiple requests on one form and incomplete forms will not receive a response. Pursuant to federal regulations, information received in response to requests made via this form will include FCOIs identified after the effective date of the regulations, August 24, 2012.

Please email the following information to: marc.kudrich@scranton.edu of the Controller’s Office within the Finance Division:

Name of requestor
E-mail address where response should be sent
Investigator's first and last name
PHS award number OR project title

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FCOI Public Request Form

Finance Department

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Finance and Treasurer