INSTRUCTION TO SPECIAL GOVERNMENT EMPLOYEES

FOR COMPLETING OGE FORM 450

1. GENERAL INFORMATION

The "Instructions for OGE Form 450, Confidential Financial Disclosure Report," which are attached to the blank Report, contain information and definitions necessary for properly completing the form. Please read these instructions carefully.

Each part of the OGE Form 450 contains pertinent information on what to report, appearing to the left of the part.

Use the "Sample OGE Form 450 for SGEs," which should have been provided with this Instruction, for guidance in completing your entries accurately. The most common types of entries are included and have been set out in an accurate format. Please follow the format to ensure that you do not omit necessary information. We know that it can be very annoying if we have to contact you for additional information, so we are trying to help you submit complete and accurate reports the first time.

If you have nothing to report in any Part of the Report, please check the NONE box to the left of the Part. Writing "N/A" in the blanks is not acceptable. If you do not check NONE, your report must be returned as incomplete. (Sorry, but the regulations give us no latitude on this.)

Use an OGE Form 450. 1/ Print legibly or type, one item per line.

Submit your completed and signed OGE Form 450 to your supervisor, point of contact, or Administrative Officer prior to your performing any work for the Government. Please submit it as soon as possible so that your supervisor can review it and send it to the before you do any work. If you don't know the address of any of the above, please send it directly to (your office & address).

If you have questions or want additional information, please contact (your name), (your office) (your number).

2. TOP SECTION

Complete each blank in the first four lines of the top section of the report.

"Position/Title" is "consultant" and a title if you have one in your Government position.

Report your series and grade as "SGE."

Under "Reporting Status," check "new entrant."

"Agency" is the office or committee in DoD to which you are appointed, as also shown in block 2 on DD Form 2292, the Request for Appointment or Renewal of Consultant.

For "Branch/Unit and Address," include your Government office symbol, if known, and location. For example, "SOCO, 3D941, The Pentagon," or "DTSA, Crystal Gateway North/Ste 303, 111 Jefferson Davis Highway, Arlington, VA 22202."

Please include your non-DoD business or home phone number so that you can be contacted if additional information is needed.

"Date of Appointment" for SGEs is the first date you perform Government work in the position.

Check the box to indicate that you are an SGE.

You must SIGN AND DATE your OGE Form 450 or it must be returned as incomplete.

3. COMPLETING PARTS I THROUGH V

The "Sample OGE Form 450 for SGEs" provides examples of what should be reported and how it should be reported on your form.

The report must contain financial interests for the 12 month period preceding the filing date.

Do not report the value of any asset, income, liability, etc.

Do not report anything in Part V. Your are not required to complete that part.

4. PART I: ASSETS AND INCOME

Report information about yourself, your spouse, and any dependent children.

Provide the complete name of each asset or source of income. If you are reporting a publicly traded mutual fund, include its complete family and specific fund name, e.g., "Vanguard Windsor II Fund" or "MFS Total Return Fund." See example on page 1, line 10, of the Sample OGE Form.

If you are reporting an employer-sponsored pension, report the name of the sponsoring employer and the fact that you have no control over investments. If you do have the ability to control or select specific holdings of the plan, you must report the sponsoring employer, that it is a contribution plan, and list the plan's holdings. See examples on page 1, lines 3 & 10, of the Sample OGE Form.

5. Part II: LIABILITIES

Report information about yourself, your spouse and any dependent children.

6. Part III: OUTSIDE POSITIONS

Report only your own positions.

Other than the listed exclusions, which appear to the left of Part III, any position held during the year, other than a Government position, must be reported, whether or not you receive compensation. These include your current employment, Directorships, and consultancies.

Please write "comp" in the last column if you received compensation, and "not comp" if you did not.

If you received over $200 in compensation, also report it under Part I. Just because you reported the compensation under Part I, don't forget to report your position here!

7. Part IV: AGREEMENTS AND ARRANGEMENTS

Report only your own agreements and arrangements.

Provide the terms and conditions of any agreement or arrangement that you have regarding future employment, payments from a former employer, or participation in an employee benefit plan. "Parties" are the persons or companies with whom you have agreements or arrangements. For example, if you have a pension, report it here, as well as in Part I.

8. Part V: GIFTS AND TRAVEL REIMBURSEMENT

Do not complete.

9. Please sign the enclosed "Disqualification Statement" and forward it with your report.

Date:

MEMORANDUM FOR

SUBJECT:	Disqualification Statement

1. I understand that my employment by the Department of Defense is a public trust that places ethical standards and the law above private gain.

2. In connection with my duties as a consultant to the	,

I am disqualified from participating in any particular matters that will have a direct and predictable effect on the following entities including their subsidiaries, affiliates or joint ventures, in which I have a financial interest.

3. The entities are:

All entities identified as financial interests on the attached financial disclosure report, except for any organization for which a waiver has ben granted pursuant to title 18, United States Code 208(b)(3).

Signature

Printed Name

ATTACHMENT 2

ENCLOSURE A