Ownership Interests. 5. Do you or a family member have or potentially have an ownership interest, such as holding shares of stock, stock options or future interests, partnership or membership interests, or other securities that could any way present or create an appearance of a potential conflict of interest ? If yes, please explain. Yes No 6. Do you or a family member have or potentially have any intellectual property interests, such as patents or royalties, related to work done for or with a Business? Yes No
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Samples: Associate Agreement Form, Associate Agreement, Associate Agreement Form