Step 1: Screening Questions

The Step One: Screening Questions orientation page displays as step one in the disclosure process. For detailed information on key terms, click the help icon.  

After reading the orientation instructions, click Continue to proceed to the screening questions.

Screening Questions

While considering events occurring since your last disclosure, answer by selecting the Yes or No option button beside the questions on the screen.

1. From any for-profit organization, did you receive in the last 12 months, or do you expect to receive in the next 12 months, salary, director's fees, consulting payments, honoraria, royalties; or other payments for patents, copyrights or other intellectual property; or other direct payments exceeding $5,000?
2. From any privately held organization, do you have stock, stock options, or other equity interest of any value?
3. Some publicly traded stock must be disclosed, but only in specific circumstances. Do you own stock, which in aggregate exceeds $5,000, in a company that provides funds to MIT in support of your Institutional Responsibilities (e.g. teaching, research, committee, or other administrative responsibilities)? When aggregating, please consider stock, stock options, warrants and other existing or contingent ownership interests in the publicly held company. Do not consider investments where you do not directly influence investment decisions, such as mutual funds and retirement accounts.
4. Publicly traded stock - Do you own stock, which in aggregate exceeds $100,000, in a company whose business or any portion thereof, could reasonably appear to be related to your MIT Institutional Responsibilities (e.g. teaching, research, or other administrative committee responsibilities)? Please aggregate stock, stock options, warrants and other existing or contentment ownership interests in the publicly held company. Do not consider investments where you do not directly influence investment decisions, such as mutual funds.
5. From US educational institutions, US teaching hospitals or US research institutions affiliated with US educational institutions: Did you receive in the last 12 months, or do you expect to receive in the next 12 months, payments for services, which in aggregate exceed $5,000 (e.g. payments for consulting, board positions, patents, copyrights or other intellectual property)? Exclude payments for scholarly or academic works (i.e. peer-reviewed (vs. editorial reviewed) articles or books based on original research or experimentation, published by an academic association or a university/academic press).
6. From foreign educational institutions, foreign teaching hospitals or foreign research institutions affiliated with educational institutions: Did you receive in the last 12 months, or do you expect to receive in the next 12 months, payments for services, which in aggregate exceed $5,000 (e.g. salary, consulting, board positions, patents, copyrights or other intellectual property)? Exclude payments for scholarly or academic works. Note: Do not include any payments or reimbursements made through MIT from foreign organizations. However, payments made directly to you must be reported.
7. From a not-for-profit organization such as a foundation or professional society, did you receive in the last 12 months, or do you expect to receive in the next 12 months, salary, director's fees, consulting payments, honoraria, royalties; or other payments for patents, copyrights or other intellectual property; or any other payments exceeding $5,000? Exclude payments for scholarly or academic works.
8. An Investigator could have a Significant Financial Interest due to financial holdings of his or her Family (spouse and dependent children). From any organization, did your Family receive in the last 12 months, or do they expect to receive in the next 12 months, payments or equity in excess of $5,000 from an organization who's line of business, or any portion thereof, could reasonably appear to be related to any of your Institutional Responsibilities (e.g. teaching, research, committee or other administrative responsibilities)? Consider all forms of equity, salary, director's fees, consulting payments, honoraria, royalties, or other payments for patents, copyrights or other intellectual property or any combination of equity and other direct payments that exceed $5,000. Exclude payments for scholarly or academic works.
9. Do you have subcontracts, purchasing or other contractual arrangements at MIT with organizations in which you have a Significant Financial Interest?

Clicking “Quit” will discard these answers and exit the Screening Questions. You will be returned to the COI Home Page and this initial disclosure will be saved. You can return at a later time to update this as a Disclosure in Process.

Click “Save & Continue” when you have answered all the questions. The next process step presented depends upon your answers to the screening questions.