# Annual policy acknowledgment form

A plain form for the annual director acknowledgment of a board policy (code of conduct, conflicts, confidentiality, insider trading, and similar).

**When to use:** Each year, and when a director joins or a policy changes.

## Policy
- Policy name:
- Version / date adopted:
- Where the current copy lives:

## Acknowledgment
I confirm that:
1. I received the current version of the policy named above.
2. I have read it and had the chance to ask questions.
3. I will follow it, and I will tell the chair (or the person the policy names) if I have something to disclose.

## Disclosures (if the policy requires any)
- None, or describe:

## Director
- Name:
- Date:
- Signature or in-app acknowledgment:

## For the secretary
- Due date for this cycle:
- Directors still owing:
- Where acknowledgments are kept:

_An acknowledgment that the policy was received is not a legal determination that anyone complied with it._

_Practice template, not legal advice. Your bylaws, policies, statutes, and counsel control._

Made with Prepared Board · https://preparedboard.com/free-templates/policy-acknowledgment · Run this in your board: https://preparedboard.com/pilot?ref=ft-policy-acknowledgment