Ethics Office: Instructions for Completing OGE Form 450

Updated 02/08/2007

Instructions for Completing OGE Form 450 (Confidential Financial Disclosure Report)

1. Why You Must File: This report is a safeguard for you as well as the Government. It provides a mechanism for determining actual or potential conflicts between your public responsibilities as a Government employee and your private interests and activities. This allows you and NRCS to fashion appropriate protections against such conflicts.


2. Who Must File: Agencies are required to designate positions at or below GS-15 in which the nature of duties may involve a potential conflict of interest. Examples include contracting or procurement, administering grants and licenses, regulating/auditing non-Federal entities, performing other activities having a direct and substantial economic effect on non-Federal entities, or law enforcement.
   
   All special Government employees (SGEs) must file, unless exempted by their agency or subject to the public reporting system. Agencies may also require certain employees in positions above GS-15 to file.


3. When to File:
   • New Entrant Reports: Due within 30 days of assuming a position designated for filing, unless your agency requests the report earlier. No report is required if you left another filing position within 30 days prior to assuming the new position. (SGEs must file new reports upon each reappointment or re-designation, at the time specified by the agency.)
   • Annual Reports: Due no later than February 15, unless extended by the NRCS Ethics Office.


4. Reporting Periods:
   • New Entrant Reports: The reporting period is the preceding twelve months from the date of filing.
   • Annual Reports: The reporting period covers October 1, 2005 through December 31, 2006 (or that portion not covered by a new entrant report). However, no report is required if you performed the duties of your position for less than 61 days during the fifteen-month period. (All reappointed or re-designated SGE's file reports, regardless of the number of days worked).


5. Where to File:  The original OGE Form 450 must be placed in a sealed envelope marked "TO BE OPENED BY ADDRESSEE ONLY Contains OGE Form 450" and addressed to:

• State Ethics Advisors for State employees
• Ethics Advisor, Fort Worth, TX, for employees of the he National Centers.
• NRCS Ethics Office, Beltsville, MD, for State Administrative Officers and national headquarters employees.

State Ethics Advisors

• Attach the position description and outside employment approval (if applicable) to each filer's OGE Form 450 Report.
• Separate and bind the forms into three groups-Negative reports and Positive Reports. and OGE-450As.
• Make a list and forward it with all OGE Form 450s to the NRCS Ethics Office by March 1. The mailing address is NRCS Office of Ethics, 5601 Sunnyside Avenue, Room 2-2290, Beltsville, MD  20705-5476.
• The Ethics Advisor, Fort Worth, TX, reviews and certifies for employees of the National Centers.  [Requires specific letter of authority from the Director, NRCS Ethics Office.] Review must adhere to OGE procedures as described in the OGE Form 450 Review Guide. These OGE Form 450 Reports are maintained in Ft. Worth, TX.

   F.    Definitions:

• Dependent Child: Means your son, daughter, stepson, or stepdaughter if such person is either:
  1. Unmarried, under age 21, and living in your household; or
  2. A "dependent" of yours for federal income tax purposes. See 26 U.S.C. 152.
• Honoraria: Means payments (direct or indirect) of money or anything of value to you or your spouse for an appearance, speech or article, excluding necessary travel expenses. Also included are payments to charities in lieu of honoraria.
• Special Government Employee: Is defined in 18 U.S.C. 202(a) as: an officer or employee of an agency who performs temporary duties, with or without compensation, for not more than 130 days in a period of 365 days, either on a full-time or intermittent basis.

1. Filers must provide sufficient information about outside interests and activities so that ethics officials can make an informed judgment regarding compliance with applicable conflict of interest laws and standards of conduct regulations.
2. This form consists of five parts, which requires the identification of certain specific financial interests and activities. No disclosure of amounts or values is required. You must complete each part (except as indicated for Part V) and sign the report.  New entrants and SGEs are not required to complete Part V.
3. You must include information applicable to yourself, your spouse, and dependent children on Parts I, II and V. This is required because their financial interests are attributed to you under ethics rules in determining conflicts of interest. Information about your spouse is not required in the case of divorce, permanent separation, or temporary separation with the intention of terminating the marriage or permanently separating. Parts III and IV require disclosures about yourself only.
4. You may distinguish any entry for a family member by preceding it with S for spouse, DC for dependent child, or J for jointly held.

Part I: Assets & Income

• Assets:
  1. Report all assets held for investment or for the production of income by you, your spouse, and dependent children, with a value greater than $1,000 at the end of the reporting period or which produced more than $200 in income during the reporting period.


• Salary and Earned Income:
  1. For yourself: Report all sources of salary and earned income greater than $200 during the reporting period.
  2. For your spouse: Report all sources of salary and earned income greater than $1,000 (for honoraria, if greater than $200).
  3. For dependent children: No earned income needs to be reported.


• Examples of Assets:
  • Stocks
  • Bonds
  • Tax Shelters
  • Investment Real Estate
  • Sector Funds (Diversified Mutual Funds do not have to be reported)
  • Pensions
  • Annuities
  • IRA/401(k) Holdings
  • Trust Holdings
  • Commodity Futures
  • Trades & Businesses
  • Partnership Interests
  • Investment Life
  • Collectibles held for Insurance Investment


• Examples of Income:
  • Investment Income
    • Dividends
    • Rents and Royalties
    • Interest
    • Capital Gains
  • Earned/Other Income
    • Fees
    • Salaries
    • Commissions
    • Retirement Benefits
    • Honoraria


• Notes:
  • For pensions, you will ordinarily just need to indicate the name of the sponsoring employer. However, if you have control over the specific investment assets held in your pension account (it is not independently managed), you must also list those underlying investments or attach an account statement that lists them.
  • For sector funds, you are only required to indicate the name of the fund, not the investments that the mutual fund holds in its portfolio. You must, however, always indicate the full name of the specific mutual fund in which you hold shares, not just the general family fund name.
  • For other publicly available investment funds, such as publicly offered units of limited partnerships, the disclosure requirements are the same as for mutual funds — list the full name of the limited partnership, but not its underlying portfolio investments.
  • For a privately held trade or business, report its name, location, and description of activity.


• Do Not Report:
  1. Your personal residence, unless you rent it out;
  2. Federal Government salary or retirement benefits such as the Thrift Savings Plan;
  3. Social Security benefits and Veterans' benefits;
  4. Money owed to you, your spouse, or dependent child by a spouse, parent, sibling or child;
  5. Accounts including certificates of deposit, savings accounts, interest-bearing checking accounts or any other forms of deposit in a bank, savings and loan association, credit union or similar financial institution;
  6. Money market mutual funds and money market accounts;
  7. U.S. Government obligations (including Treasury bonds, bills, notes and savings bonds);
  8. Government securities issued by U.S. Government agencies or Government-sponsored corporations, such as TVA GNMA, FNMA; and
  9. The underlying holdings of a trust that: 1) was not created by you, your spouse, or dependent children, and 2) the holdings or sources of income of which you, your spouse, and dependent children have no past or present knowledge. An example is a trust created by a relative, from which you receive periodic income but have no knowledge about its assets. Just identify the trust by name and date of creation.
  10. Dependent child's earned income.

Part II: Liabilities

• Report for Yourself, Spouse, and Dependent Children:
  1. Liabilities over $10,000 owed to any creditor at any time during the reporting period.


• Do Not Report:
  1. Mortgages on your personal residence unless you rent it out;
  2. Personal liabilities owed to a spouse, or the parent, sibling, or child of you, your spouse, or dependent child;
  3. Loans for personal automobiles, household furnishings, or appliances, where the loan does not exceed the purchase price; and
  4. Revolving charge accounts where the outstanding liability does not exceed $10,000 at the end of the reporting period.

Part III: Outside Positions

• Report for Yourself:
  1. All positions outside the U.S. Government held at any time during the reporting period (including positions no longer held), whether or not paid.
     
     Positions include an officer, director, trustee, general partner, proprietor, representative, executor, employee, or consultant of any of the following:
     1. A corporation, company, firm, partnership, trust, or other business enterprise;
     2. A non-profit organization
     3. A labor organization; and
     4. An educational or other institution outside the Federal Government.
  
  
• Do Not Report:
  1. Positions held in any religious, social, fraternal, or political entity;
  2. Positions solely of an honorary nature; and
  3. Positions held by a spouse or dependent child.

Part IV: Agreements and Arrangements

• Report Your Agreements or Arrangements for:
  1. Current or future employment;
  2. A leave of absence from private or other non-Federal employment;
  3. Continuation of payment by a former employer other than the Federal Government (including severance payments); and
  4. Continuing participation in an employee pension or benefit plan maintained by a former employer other than the Federal Government.


• Do Not Report:
  1. A spouse or dependent child's agreements or arrangements.
  2. Any agreement or arrangement related to your employment by the Federal Government.

Part V: Gifts and Travel Reimbursement

Part V is not applicable to new entrants or SGEs.

• Report for You, Your Spouse, and Dependent Children:
  1. Travel-related cash reimbursements received from one source during the reporting period totaling $305 or more.
  2. Any other gifts totaling $305 or more from any one source. A "gift" is defined as anything of value, unless you give something of equal or greater value to the donor. This includes tangible items and in-kind transportation, food, lodging, and entertainment.
     
     Note: Gifts or reimbursement valued at $122 or less need not be included in determining the $305 reporting threshold.


• Do Not Report:
  1. Anything received from relatives, the U.S. Government, D.C., State or local governments;
  2. Bequest and other forms of inheritance;
  3. Gifts and travel reimbursements given to your agency in connection with your official travel;
  4. Gifts of hospitality (food, lodging, entertainment) at the donor's residence or personal premises; and
  5. Gifts or reimbursements received by a spouse or dependent child totally independent of the relationship to the filer (Example: a spouse's reimbursement in connection with private employment).

Privacy Act Statement

Title I of the Ethics in Government Act of 1978 (5 U.S.C. App.), Executive Order 12674, and 5 CFR Part 2634, Subpart I, of the Office of Government Ethics regulations require the reporting of this information. The primary use of the information on this form is for review by Government officials of your agency, to determine compliance with applicable Federal conflict of interest laws and regulations. Additional disclosures of the information on this report may be made: (1) to a Federal, State or local law enforcement agency if the disclosing agency becomes aware of a violation or potential violation of law or regulation; (2) to a court or party in a court of Federal administrative proceeding if the Government is a party or in order to comply with a judge-issued subpoena; (3) to a source when necessary to obtain information relevant to a conflict of interest investigation or decision; (4) to the National Archives and Records Administration or the General Services Administration in record management inspections; (5) to the Office of Management and Budget during legislative coordination on private relief legislation; and (6) in a judicial or administrative proceeding, if the information is relevant to the subject matter. This confidential report will not be disclosed to any requesting person unless authorized by law.

Penalties

Falsification of information or failure to file or report information required to be reported may subject you to disciplinary action by your employing agency or other authority. Knowing and willful falsification of information required to be reported may also subject you to criminal prosecution.

Public Burden Information

This collection of information is estimated to take an average of one and a half hours per response, including time for reviewing the instructions, gathering the data needed, and completing the form. Send comments regarding the burden estimate of any other aspect of this collection of information, including suggestions for reducing this burden, to Associate Director for Administration, U.S. Office of Government Ethics, Suite 500, 1201 New York Avenue NW, Washington, DC 20005-3917; and to the Office of Management and Budget, Paperwork Reduction Project (3209-0006), Washington, DC 20503. Do not send your completed OGE Form 450 to this address. See Section E for where to file.

Pursuant to the Paperwork Reduction Act, as amended, an agency may not conduct or sponsor, and no person is required to respond to a collection of information unless it displays a currently valid OMB control number (that number is displayed in the upper right-hand corner of the first page of this OGE Form 450).

Mere disclosure of the required information does not authorize holdings, income, liabilities, affiliations, positions, gifts or reimbursements which are otherwise prohibited by law, Executive order, or regulation.

If you need assistance in completing this form, contact your servicing Ethics Advisor.

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