• Review the DHCS Conflict of Interest Code  to determine the need to file a Statement of Economic Interests Form 700.
• Locate the Statement of Economic Interests Form 700 on the Fair Political Practices Commission (FPPC) Website.
• Complete the Statement of Economic Interests Form 700 and affix an original signature and date.  (Statement of Economic Interest Form 700 cannot be officially filed without an original signature.) 
• Complete the Supervisor Review Transmittal Form DHCS 9048.
• Submit both documents to the assigned supervisor for review and signature on the DHCS 9048. 
• Ensure both completed original documents are forwarded to the DHCS Statement of Economic Interests Filing Officer in the Human Resources Branch within the applicable timeframe. 
  

First Supervisory Level Responsibility

• Review the DHCS Conflict of Interest Code  to determine if the employee needs to file a Statement of Economic Interests Form 700.
• Review the employee’s completed Statement of Economic Interests Form 700 to determine if any conflicts of interest exist between the employee’s alternate sources of income and his/her assigned DHCS duties.
• Ensure that the form is complete.
• Ensure the employee’s original signature is affixed to the Statement of Economic Interests Form 700.
• Complete the first supervisory level section of the Supervisor Review Transmittal Form DHCS 9048. If no original reportable interest are disclosed no other action is required.  Follow your assigned program’s procedure of either submitting the forms to the program’s Conflict of Interest Liaison or directly to the Statement of Economic Interest Filing Officer in the Human Resources Branch.
• If reportable interests are disclosed, forward the documents to the next supervisory level for final review and signature on the Supervisor Review Transmittal Form DHCS 9048.  If first supervisory level is a Deputy Director, or above, the forms do not require a second supervisory level of review.

Second Supervisory Level Responsibility

• Review the employee’s completed Statement of Economic Interests Form 700 to determine if any conflicts of interest exist between the employee’s alternate sources of income and his/her assigned DHCS duties. 
• Ensure that the form is complete.
• Ensure the employee’s original signature is affixed to the Statement of Economic Interests Form 700.
• Ensure that that the first supervisory level section of the Supervisor Review Transmittal Form DHCS 9048 is complete.
• Complete the second supervisory level section of the Supervisor Review Transmittal Form DHCS 9048.
• Follow your assigned program’s procedure of either submitting the original forms to the program’s Conflict of Interest Liaison or directly to the Statement of Economic Interests Filing Officer in the Human Resources Branch.

Conflict of Interest Liaison Responsibility

• Review the employee’s Statement of Economic Interests Form 700 and the Supervisor Review Transmittal Form DHCS 9048 to ensure that both forms have been completed.
• Ensure the employee’s original signature is affixed to the Statement of Economic Interests Form 700.
• Submit all original, completed forms to the Statement of Economic Interests Filing Officer in the Human Resources Branch for official filing.
• Maintain a list of positions in which the duties performed meet the DHCS Conflict of Interest Code filing criteria.
• Ensure the completion, within the deadline, of Statement of Economic Interests Form 700 by new hires and employees leaving positions designated as subject to the DHCS Conflict of Interest Code.
• Notify the Statement of Economic Interests Filing Officer of any employees/positions that should be deleted/added to the master Form 700 filing database.