UNIVERSITY OF LOUISVILLE ATHLETIC ASSOCIATION, INC. BOARD OF DIRECTORS
CONFLICT OF INTEREST STATEMENT YEAR 7/1/2016 6/30/2017

Organization UNIVERSITY OF LOUISVILLE


Name of Individual 

Signature 


Business Transaction with UofL

 

1. Other than an employment relationship, do you or a family member conduct business with the UofL?
Business transactions include, but are not limited to contracts of sale, lease, license and performance
of services, whether initiated during the UofL tax year or ongoing from a prior year. Business
transactions also include joint ventures in which either the profits or capital interest of the UofL and I: 
of the interested person exceeds 10%.

if "Yes,? describe your business transactionis) with the UofL:

 

2. Do you or a family member own 35% of an entity (C-corporation, S-corporation, Partnership, LLC or 
other entity type(s), directly or indirectly, that conducts business with the UofL?

 

If ?Yes," describe your business transactionis) with the UofL:

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family member, in combination with other "interested personls)" own 35% of an
entity (CZ-corporation, S-corporation, Partnership, LLC or other entity type), directly or indirectly,
that conducts business with the UofL?

if "Yes," describe your business transaction(s} with the UofL:

Do you or a family member, serve as an officer, director, trustee, or key employee or an entity
that does business with the UofL?

If "Yes,? describe your business transaction(s) with the UofL:

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ownership Interest in excess of 5% of a partnership or professional corporation) that conducts
business with the UofL?

if "Yes,? describe your business transaction(s) with the UofL:

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Page 2 of 4

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6. Did a family member receive a compensation payment in excess of $10,000 from the UofL? 

If "Yes,? explain:

7. Did you or a family member receive grants or other assistance, including provision of goods,
services, or use of facilities from the UofL? Grants include scholarships, fellowships, internships, Ci
prizes, and awards. 

if "Yes," explain:

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8. yuu Ilavc as? cum. on tildl. leu?ved grants or other assistance, including provision L.J A
of goods, services, or use of facilities from the UofL?

If "Yes," explain:

I 9. Do you have any loans to or from the UofL? 

0 If "Yes," explain.

10. Are you aware of any excess benefit transactions to report? An excess benefit transaction is 
where the UofL directly or indirectly provided an economic benefit where the value of the
benefit exceeds the value of the consideration received by the UofL.

Page 3 of 4

 If ?Yes,? explain.

Business and Family Relationships with interested Persons

11. Do you have a family or business relationship with any other officer, director, trustee, or key
employee of the UofL?

For each family and business relationship, identify the persons and indicate family or business
relationship.

Page 4 of 4

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