1.  I understand that:

A. “Interests” refer to any financial or non-financial links with the tobacco industry, including through employment, consultancy, research, business, professional or personal interests, contributions or gifts, family’s or spouse/partner’s interests, relationships up to the fourth degree of consanguinity and affinity, and frequent or regular social relationships.

B. “Tobacco industry” refers to (a) any tobacco or tobacco product (including electronic nicotine delivery systems (ENDS) and heated tobacco products [HTPs]) manufacturer, processor, wholesale distributor, importer , (b) any parent, affiliate, branch, or subsidiary of a tobacco or tobacco product (including ENDS and HTPs) manufacturer, wholesale distributor, importer, retailer, or (c) any individual or entity, such as, but not limited to an interest group, think tank, advocacy organization, lawyer, law firm, scientist, lobbyist, public relations, and/or advertising agency, business, or foundation, that represents or works to promote the interests of the tobacco and nicotine industry, including, but not limited to those listed in tobaccotactics.org.

2. I declare that, other than the interests declared in the form below, I do not have interests, currently or in the past five (5) years, related to the tobacco industry, and I am not knowingly representing or receiving any contribution or compensation, directly or indirectly, whether financial or otherwise, from the tobacco industry.

3. I certify that the information given above is, to the best of my knowledge, true, accurate, and complete.

4. I agree to continually update my knowledge about the persons or entities that are considered “tobacco industry.” Should there be any change to the above information before, during, or within one month after the meeting, I will promptly notify the organizers of such changes.

Confidentiality undertaking

5. I understand that:

A. “Confidential Information” refers to all information, facts, data, and other matters of which I acquired knowledge, either directly or indirectly, as a result of my participation in activities relating to this meeting.

B. “Confidential Documents” refer to all drafts, preparatory information, documents, and other material, to which I have access, directly or indirectly, as a result of my participation in activities relating to this meeting.

C. Confidential Information excludes information which (a) I independently developed without reference to the matters or discussions arising from the proposal development/ project implementation; (b) is or becomes publicly known or publicly available; (c) is disclosed to me by a third person who is not required to maintain its confidentiality.

6. Subject to the requirements of law and my legal duties, I will not discuss/ disclose or authorize another to disclose, at any time during my work or at any time thereafter, any Confidential Information with/ to any third party, employee, agent, grantees, or other entities, other than those working or advising on the this meeting or those who need to access such information on a strict need-to-know basis.

7. I agree to continue to comply with confidentiality provisions after the termination of this meeting.