Form Use:

Form 15.01.03- Disclosure of Financial Interests Related to Federal and Other Sponsored Projects Adopting the Federal Requirements
The 15.01.03 FCOI form is required for contract and grant proposals being submitted to:

• National Institutes of Health (NIH): which include these types of proposals/disclosures:
  • New
  • Renewal
  • Resubmission
  • Continuation
  • Competitive Supplement
  • Change of Principal Investigator
  • Adding a Researcher to the Project
  • Subaward
  • SBIR - Small Business Innovation Research
  • STTR - Small Business Technology Transfer

• Department of Health and Human Services (DHHS): 8 agencies within DHHS, including NIH, require the 15.0103 form. Those DHHS agencies are:

1. AHRQ - Agency for Healthcare Research and Quality
2. ATSDR - Agency for Toxic Substances and Disease Registry
3. CDC - Centers for Disease Control and Prevention
4. FDA - Food and Drug Administration
5. HRSA - Health Resources and Services Administration
6. IHS - Indian Health Service
7. NIH - National Institutes of Health
8. SAMHSA - Substance Abuse and Mental Health Services Administration

• National Science Foundation (NSF): which include these types of proposals/disclosures:
  • New
  • Renewal
  • Change of Principal Investigator
  • Adding a Researcher to the Project

• American Cancer Society (ACS): For Research Scholars; which includes these types of proposals/disclosures:
  • New
  • Resubmission
  • Change of Principal Investigator
  • Add Researcher to the Project

• American Heart Association (AHA): South Central and National; which includes these types of proposals/disclosures:
  • New
  • Resubmission
  • Change of Principal Investigator
  • Add Researcher to the Project

• Subawards:
  • Applies to entities with funds originating from all agencies mentioned above; NIH, the 8 DHHS agencies, NSF, and AHA.

Please Note: The receiving entity is required to supply assurances that will allow the University to comply with NIH, NSF, some DHHS agencies,  and AHA regulations.

Form Submitted:

The Form 15.0103 must be completed and submitted with the funding proposal to the appropriate reviewing office:

• OCGA - Office of Contract and Grant Administration; Campus

Please Note: An original signature is always preferred, however faxed signatures will be accepted.

Form Access:

• PDF
• Form Overview