Signature Statement: By signing this form you (1) certify that you have read the Wisconsin Tennis Association Incorporated’s Conflict of Interest and Disclosure Policy; (2) certify that the information contained in this form (including any supplemental information, if any) is complete and accurate to the best of your knowledge; and (3) acknowledge your continuing obligation to complete and submit a new Conflict of Interest and Disclosure Form when there is any actual or anticipated significant change in your or your Family Members outside activities or related Financial Interests.