APPENDIX I- INDUSTRY CONTROLLED OTHER PARTY (ICOP)
DECLARATION FORM FOR OTHER PARTY (OP) ASSESSORS CONDUCTING
9104 OVERSIGHT

I ______
(Enter full name)

An employee of______

(Full name and address of employer)

______

declare not to be personally and financially committed with any outside organization involved in the Aerospace Industry Controlled Other Party (ICOP) scheme. In case of any contract or link with some of these organizations (National Accreditation Body [NAB], Certification Body [CB], etc.), I declare hereunder all the ones where I am associated with and the tasks I am in charge of:

Organization nameCountryTasks

______

______

I understand this information is to be used by the Sector Management Structure (SMS) to avoid any conflict of interest as described in Section 10 of 9104-2.

In addition, I agree that any information in respect of a specific SMS, Certification Body Management Committee (CBMC), NAB, CB, Auditor Authentication Body (AAB), Training Provider Certification Body (TPAB) or its client’s, that is acquired as a member of the Other Party Management Team (OPMT) or as Other Party Assessor of a national CBMCs shall be kept confidential and not copied, distributed or published to anyone not a member of the IAQG OPMT a Regulatory Agency, unless with written permission of the organization concerned is obtained.

The above agreement shall not apply if the information is either published, or otherwise legitimately in the public domain, or lawfully obtained from a party free to divulge it.

The above declaration will remain confidential and for the use of ICOP SMS only.

Signature:______Date:______

Job Title:______

OP Assessor’s Company Representative

I declare, to the best of my knowledge, that qualification records are on file and the above assessor conforms with the qualification requirements outlined in 9104, section 5.2.

Signature:______Name:______

Job Title:______Date:______

This declaration form shall be submitted to the respective SMS Oversight Chair for retention and objective evidence of declaration.