Nepotism Good Cause Exception Application

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Nepotism Good Cause Exception Application

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Applicant Information

If you have questions about the definition of a household member or relative, or how the nepotism law works, please see Quick Guide to Nepotism

Applicant’s Name (Name of the state employee hiring or supervising a household member or relative who seeks an exception to the nepotism law)(Required)

Applicant’s State Position(Required)

State Agency(Required)

Address(Required)

Street Address Address Line 2 City State Zip Code

Email (Applicant)(Required)

Phone(Required)

Date of Hire(Required)

MM slash DD slash YYYY

If Applicant is different from relative or household member requiring good cause exception

If you have questions about the definition of a household member or relative, or how the nepotism law works, please see Quick Guide to Nepotism

Relative or household member (Name of person being hired or supervised by a state employee)

Relative or household Member’s Current or Proposed State Position

Relative or household Member’s Current or Proposed State Agency

Address

Street Address Address Line 2 City State Zip Code

Relative or Household Member’s email address

Phone

Date of Hire, if applicable

MM slash DD slash YYYY

Person filling out this form if not the hiring/supervising applicant. If you are the hiring/supervising applicant, please skip this page)

If you have questions about the definition of a household member or relative, or how the nepotism law works, please see Quick Guide to Nepotism

Person filling out this form if not the hiring/supervising applicant

Nature of relationship with applicant

State position (if applicable)

State agency (if applicable)

Address

Street Address Address Line 2 City State Zip Code

Phone

Please answer the following questions

If you have questions about the definition of a household member or relative, or how the nepotism law works, please see Quick Guide to Nepotism

Will the applicant supervise the relative/household member? If so, how?

Describe applicant's potential interactions with the relative/household member at work

If the exception pertains to a new hire, please describe the dates and method the position was advertised and the number of applicants received

If you have questions about the definition of a household member or relative, or how the nepotism law works, please see Quick Guide to Nepotism

If the exception pertains to a contract with a relative’s business, please describe the dates and methods the contract was advertised, and the number of businesses that submitted bids for that contract

If the exception pertains to a contract with a relative’s business, please describe the employee’s potential interaction with the relative or household member’s business

If you have questions about the definition of a household member or relative, or how the nepotism law works, please see Quick Guide to Nepotism

Why should a good cause exception be granted?

Are there ways to avoid the potential conflict with the Relative/Household member (e.g., re-assigning the person to a different unit/branch/supervisor, etc.)?

Date by which a decision is necessary

MM slash DD slash YYYY

Any additional information relevant to this application

Certification Statement(Required)

I certify that the information I am submitting in this form is true, correct and complete to the best of my knowledge and belief. I also certify that I understand that there are statutory penalties for failing to report the information required by Hawaii law.

Hawai‘i State Ethics Commission

Nepotism Good Cause Exception Application

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