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Nepotism Good Cause Exception Application
Nepotism Good Cause Exception Application
Step
1
of
6
16%
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
Email
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.