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Ða€written,€signed€disqualification€statement.€€ò òA€new€disqualification€statement€must€beÐ ¸$ " Ðfiled€each€year€with€each€new€report.ó ó€€Make€sure€the€SGE€is€not€given€any€workÐ ¨%ø # Ðassignments€involving€that€company€or€any€of€its€subsidiaries,€affiliates,€or€joint€ventures.Ð ½(#½(# ÐÌÔ€ô£ õXXíõÔð,ðÔ€XíõXõô£ Ôà0 ½ àAfter€you€sign€and€date€the€report,€place€it€in€a€sealed€envelope€marked:€ò òTO€BEÐ x(È#& ÐOPENED€BY€ADDRESSEE€ONLYó ó.€€€Hand€carry€or€mail€the€sealed€envelope€to€ñXñ(yourÐ h)¸$' Ðoffice)ñXññYñDoD€SOCOñYñ,€or€òòóómake€arrangements€to€send€it€to€your€Admin€Officer€to€be€forwarded€to€ñZñ(yourÐ X*¨%( ÐofficeñZññ\ñ€&€ñ\ññ]ññ\ñyour€ñ\ññ]ññ^ñaddressñ^ññ\ññ\ññZñ)ñZññ[ñÔ_ÔSOCOÔ_Ô€at€Office€of€General€Counsel,€16Ô% € Ô00€Defense€Pentagon,€Washington,€DCÏ20301-1600ñ[ñ.€Ð H+˜&)½(#½(# ÐOffice€Symbolà ¸ àà  àà h àà À àà  àà p àà È àDateÐ ° ÐÌÌMEMORANDUM€FOR€òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÐ €Ð Ðà ½ àà ` àà ¸ à€€€€Name€and€Title€of€SupervisorÌÌà ½ àà ` àà ¸ à€€€€òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÐ P   Ðà ½ àà ` àà ¸ à€€€€Office€of€CounselÌÌÌSUBJECT:à0 ` àDisqualification€Concerning€Financial€Interests€in€Certain€DoD€ContractorsÐ` ` (#` (# ÐÌÌà ½ àBecause€of€financial€interests€in€the€companies€listed€below,€during€the€period€of€myÏservice€with€the€Department€of€Defense€or€until€further€notice,€I€am€disqualified€from€taking€anyÏaction€that€might€affect€them.ÌÌà ½ àIn€the€event€that€any€matter€brought€to€me€for€action€may€have€a€direct€or€predictableÏimpact€upon€these€companies,€I€will€immediately€inform€you€and€arrangements€will€be€made€toÏensure€that€I€am€not€involved.ÌÌà ½ àThe€employee€who€will€be€handling€these€actions€during€my€disqualification€follows:ÌÌà ½ àThe€companies,€including€their€subsidiaries,€affiliates€and€joint€ventures€include:ÌÌÌÌÌà ½ àà ` àà ¸ àà  àà h àà À àòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÐ ð@ Ðà ½ àà ` àà ¸ àà  àà h àà À àName€and€title€of€employeeÌÌcc:ÌÌReceived:€òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóà À àà  àà p àDate:€€òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÐ  #ð! Ðà ½ à€€€€€€€Name€and€title€of€immediate€supervisorÌÌà ½ à€€€€€€€òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóà À àà  àà p àDate:€€òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÐ p&À!$ Ðà ½ à€€€€€€€CounselÐ  `'°"% ÐÑ  Ñà@ññ*ìàATTACHMENT€4