# Commission Implementing Regulation (EU) 2019/652 of 24 April 2019 laying down standard Rules of Functioning for the Advisory Commission or Alternative Dispute Resolution Commission and a standard form for the communication of information concerning publicity of the final decision in accordance with Council Directive (EU) 2017/1852, Part 2: DISCLOSURE OF ANY CONFLICTS OF INTEREST

Extent: E+W+S+N.I.

[To be filled in by each appointed independent person of standing and his or her substitute]
Family name: …
First name: …
Appointed by: …
…
…
This disclosure does not discharge my ongoing duty to disclose any facts and circumstances that might affect my independence.
Date:
Signature of the appointed independent person or his or her subsitute:
…

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Source: https://www.legislation.gov.uk/eur/2019/652/annex/I/part/2 (the official version)
Page: https://openlegislation.uk/eu-regulation-2019-652/annex-I/part-2
Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives.