Contractor Conflict of Interest Form

COMPLETED BY CONTRACTOR
A: Information

Talha Jilal Req # 52345-1

B. Outside Activity Information

Outside Outside Employment (Will you be compensated elsewhere during this engagement)
Activity: Business Ownership (Do you have a business registered in your name INC, PART,SP)
(please What is your percentage ownership?
check)
External Directorship (Are you listed on another Business’s documentation as a shareholder or director)
Is Compensation received? YES NO
Other (provide details): ___________________________________________________________________

No outside employment or business ownership):

Company / Corporation name: Description of Company / Corporation:

How long have you worked at /been Does this position interact with customers? Hours worked per week:
involved with this company? YES NO

Description of outside activity and your accountabilities:

C. Potential Conflict of Interest Information – Business Relationship

Is the outside Company a bank, other financial institution or involved in the securities business? YES NO
Are you aware of a business relationship with BMO? YES NO
D. Candidate Acknowledgement
Candidate Signature: Date: