As promised, and as required by department guidelines, the Department's
Commercialization Oversight Committee is preparing a web page listing
all commercialization activities wherein faculty, staff, or students
have a financial interest and where there is some potential for conflict
of interest. Once posted, the page will be restricted to CSENetID access,
meaning only those with valid CSE accounts will be able to view it.

Each entry will contain:
Person's name and university position
(faculty, staff, grad student, undergrad)
Company or activity name and address
Type(s) of interest:
- owner / founder/ principal
- officer / board member of a for-profit entity
- stock or option-holder of a non-publically traded company
- employee (other than of UW)
- consultant to a company for which you expect another
department member to disclose a financial interest
- lender to/investor in a company for which you expect another
department member to disclose a commercialization activity
- any interest subject to SEC insider trading regulations
- other (please specify)
Date of Initial Interest

The page will also contain a cross-reference listing all people associated
with each company named by any individual.

Our definition of when you have "such a financial interest" is:
1. Any of the activities listed above.
2. If a reasonable person would like to know about this interest if
the person were involved with you in some University capacity,
such as your student, teacher, employer, employee, evaluation
committee member, or research colleague, and where your University
or commercialization activity decisions may affect this person
or the University.

If your are in doubt about whether either of these applies, the answer is
almost certainly that you DO have an interest that should be disclosed.

If you have a commercial interest but are in a stage where you are REQUIRED to
keep this information confidential at this time, you may defer disclosure until
a more appropriate time, so long as you reasonably expect disclosure to
be possible within the next academic quarter and you can avoid any conflict
of interest situation until such disclosure.
If the quarter passes and you cannot publically
disclose, you should contact the Commercialization Oversight Committee.

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All faculty should respond to the following brief survey. Staff are
being asked to respond by email. Students are not being asked to respond;
instead, we are asking you to list any involved students.
***********************************************************************
Information on commercialization appears in the web site:
http://www.cs.washington.edu/commercialization/

COC: Alan Shaw (ch), John Zahorjan

________________________________________________________________________
Department of Computer Science and Engineering Winter, 2001

Commercialization Oversight
Faculty Survey of Potential Conflict of Interest Activities

Your Name:

I do/do not have a financial interest in a commercialization activity
where there is some potential for conflict of interest.

If you do have such an interest, please complete the rest of the form.
Otherwise, your response is completed.

For each activity, fill in the following:

Name and Address of Company or Activity:

Type(s) of Interest:

Date of Initial Interest:

Name(s) of Involved Students:

Thanks for your cooperation. Please return the completed survey to:
Alicen Smith

Department COC