Security Clearance Business Unit
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Pre-Interview Conflict of Interest Questionnaire
For Boeing Subsidiary Candidates
The Boeing Company is a government contractor and does business all over the world. Governments impose certain regulatory requirements that affect Boeing, its employees, and candidates for employment. Boeing reviews all potential hires as part of its anti-corruption program. In order to ensure compliance with these regulatory requirements, Boeing requires all applicants to complete this form.
Throughout this Conflict of Interest (COI) questionnaire, "Boeing" refers to any business unit, operating group or function of The Boeing Company and its subsidiaries. If you are a government employee, you know the importance of complying with conflict of interest laws restricting the discussion of possible employment with government contractors. Failure to comply with such laws can result in severe penalties for you and Boeing. Therefore, we require all government employees to complete questions that relate to your employment. Boeing requires you to provide a copy of any applicable disqualification, recusal, ethics opinion, or other writing that evidences your compliance with these laws.
Do not include classified, controlled unclassified, security clearance, or other sensitive information in your responses.
All questions must be answered completely and accurately. Subsidiary Name:
1) Do your current job duties involve Boeing?
You should answer "Yes" if your job duties involve any of the following conditions:
• Test (e.g., you are a test pilot), acceptance, inspections, safety rulings, or approval of Boeing products or services; or
• Financial responsibilities including work on contracts, procurements, program management, funding decisions, trade issues, claims, and import or export licenses; or
• Audits, investigations, and litigation; or
• Serving as an employee of the U.S. Federal Aviation Administration (FAA), U.S. Defense Contract Audit Agency (DCAA), U.S. Defense Contract Management Agency (DCMA) or an equivalent non-U.S. government agency.
NOTE: You may answer "No" if you are currently:
• An employee of a Boeing subsidiary; or
• Employed as a contractor for Boeing or contract hire through an agency or consulting firm; or
PRE-INTERVIEW CONFLICT OF INTEREST QUESTIONNAIRE
For Boeing Subsidiary Candidates
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• A pilot with a United States based commercial airline, cargo or charter company flying Boeing products; or
• Performing routine machine maintenance, repairs and service on Boeing Products.
Yes No
If "Yes", please provide a full explanation.
2) Are you currently employed by or serving in OR have you formerly been employed by or served in
(full-time or part-time) any of the following positions listed below? If yes, you must select all the appropriate options below and complete sub-questions A through F.
U.S. military officer on active duty at the rank of O-5 or above within the last five (5) years;
U.S. military officer in the military reserves or National Guard at the rank of O-5 or above within the last five (5) years;
U.S. Federal Government civilian employee at a grade equivalent to GS-13 or above within the last five (5) years;
U.S. state, city, county, or local government civilian employee at a grade equivalent to a GS-13 or above in the Federal Civil Service within the last five (5) years;
Special Government Employee in the U.S. Government (e.g., as a member of an advisory board, panel, or committee) within the last one (1) year;
United States Federal Aviation Administration Flight Standards Service Aviation Safety Inspector within the last two (2) years; or
None of the Above.
If you checked “Yes”, you must provide the following information for each position you hold or held:
a. Name of the government agency, department, military branch, or office b. Your position or title for all positions held in the last five (5) years c. Dates of employment for all positions held in the last five (5) years d. Your military rank or civilian pay grade for all positions you held within the last five (5) years
PRE-INTERVIEW CONFLICT OF INTEREST QUESTIONNAIRE
For Boeing Subsidiary Candidates
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e. A brief job description for each position held
f. Date of separation from your government or military employment, if applicable 3) At any time within the last five (5) years, have you been employed (full-time or part-time) as an officer or employee, or in any other official capacity on behalf of: A. A public international organization (such as the World Trade Organization, the International Civil Aviation Authority Organization or the World Bank); B. A non-U.S. government, department, agency or state-owned, controlled or operated entity (including a military service or civil aviation authority); or C. A non-U.S. political party or a candidate for a non-U.S. political office.
Yes No
If you checked "Yes", you must provide the following information for each position you hold or held:
a. Is this a current position?
Yes No
b. Name of public international organization, non-U.S. government agency or department, state-owned entity, military branch, political party or office c. Your position or title for all positions held in the last five (5) years d. Dates of employment for all positions held in the last five (5) years e. Your military rank or civilian pay grade for all positions you held within the last five (5) years
f. A brief job description for each position held
g. Did you or do you still have decision making authority or influence over matters involving Boeing? If "Yes", briefly describe the type of decision making authority and/or influence you exercised. Please enter "No" if you do NOT have decision making authority or influence in matters involving Boeing.
PRE-INTERVIEW CONFLICT OF INTEREST QUESTIONNAIRE
For Boeing Subsidiary Candidates
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4) At any time within the last two (2) years, have you been employed as a manager, executive, officer, or controlling shareholder of a non-U.S. airline or aircraft holding company?
Yes No
If "Yes", please provide the following information for each position that applies: a. Name of non-U.S. airline or aircraft holding company b. Your position or title
c. Dates of employment for all positions held in the last two (2) years d. A brief job description for each position held
e. Did you or do you still have decision making authority or influence over matters involving Boeing, such as the procurement of products or services or approval for technical acceptance? If "Yes", briefly describe the type of decision making authority and/or influence you exercised. Please enter "No" if you do NOT have decision making authority or influence in matters involving Boeing. 5) To the best of your knowledge, do you have a "family member" who currently works for:
(A "family member" includes spouses, parents, step-parents, legal guardians, mothers-in-law, fathers-in-law, children, step-children, siblings, sons-in-law, daughters-in-law, sisters-in-law, brothers-in-law, grandparents, spouse’s grandparents, grandchildren, uncles, aunts, nephews, nieces, and first cousins.)
(A) A non-U.S. government, including, a military, state-owned entity or civil aviation authority;
(B) A public international organization (such as the World Trade Organization, the International Civil Aviation Organization or the World Bank); or
(C) A non-U.S. airline or aircraft holding company as a manager, executive, officer, or controlling shareholder.
Yes No
If "Yes", please provide the following information: a. Name of the family member
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For Boeing Subsidiary Candidates
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b. Family member’s relationship to you
c. Name of the non-U.S. government, military, agency or department, state-owned entity, civil aviation authority, public international organization, or non-U.S. airline d. Family member's title or position
e. A brief job description
f. Does your family member(s) have decision making authority or influence over matters involving Boeing? If "Yes", please briefly describe the type of decision making authority and/or influence exercised. Please enter "No" if your family member does NOT have decision making authority or influence in matters involving Boeing.
6) Boeing engages Deloitte, LLP for auditing purposes. This question identifies personal and family connections to Deloitte, LLP. At any time within the last four (4) years from today’s date, have you or a "close family member" been employed (full-time or part-time) by Deloitte, LLP?
(A "close family member" includes a person’s spouse, spousal equivalent, parent, dependent, nondependent child or sibling. "Deloitte, LLP" includes Deloitte LLP, Deloitte and Touche LLP, Deloitte Tax LLP, Deloitte FAS LLP, and Deloitte Consulting LLP, as well as any affiliates of such entities.)
Yes No
If "Yes", you must provide the following information for each person and position(s) held: a. Name of person(s) employed by Deloitte, LLP (including yourself) b. Family member’s relationship to you
c. Position(s), title(s), and level(s)
d. Start and end date(s)
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For Boeing Subsidiary Candidates
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e. Briefly describe the professional services you or the close family member provided to Boeing while employed by Deloitte, LLP within the last four (4) years 7) Describe how you found out about this job. For example, did you receive a referral or are you responding to an advertisement or a call from a recruiter? If you received a referral, please explain who referred you, your relationship, and how the referral came about. After completing the questionnaire, please sign and date the form below. An electronic signature is acceptable. Then, return the completed form to your recruiter via email. Thank you! Full Legal Name (Signature) Date
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