DOE N 326.3, Annual Confidential Financial Disclosure Report

Some DOE employees must file a Public Financial1 Disclosure Report (SF 278) which is due by May 15 each year. These employees are those occupying Senior Executive Service, Executive Schedule, and Senior-Level positions or the equivalent, members of the Board of Contract Appeals, special Government employees who work more than 60 days per year and are paid (without locality pay) at a daily rate at or above $319, Schedule C appointees, members of the uniformed services whose pay grade is 0-7 or above, and Administrative Law Judges. DISTRIBUTION: INITIATED BY: All Departmental Employees Office of the General Counsel DOE N 326.3 9-30-96 Expires: 11-30-96 U.S. Department of Energy NOTICE Washington, D.C. SUBJECT: ANNUAL CONFIDENTIAL FINANCIAL DISCLOSURE REPORT (SF 450/OGE 450) This Notice addresses the Executive Branch confidential financial disclosure requirements. These requirements apply to persons employed at the GS-15 level and below, except for Schedule C appointees. 1 Forms: The Office of Government Ethics has revised the form for the Executive Branch Personnel Confidential Disclosure Report (SF 450) and published a new form, OGE 450. Filers may use either the SF 450 or OGE 450. The OGE 450 form has updated instructions and examples to aid the filer. Forms are available from your Administrative Officer. Those DOE employees who used the SF 450 computer software to complete their report last year should use that software this year to update their report. Electronic filing is not permitted. Therefore, an employee who uses the software must print out a hardcopy of the report and sign that original. Who must file: All employees who occupy positions at GS-15 and below must file the 450 report, unless they were required to file a Public Financial Disclosure Report (SF 278) or occupy a position that is exempt from filing as shown on the list at the end of this Notice. The exemptions, however, do NOT apply to any employee who holds a contracting officer CANCELE D CANCELE D 2 DOE N 326.3 9-30-96 warrant or who serves as a contracting officer's representative or contracting officer's technical representative. All employees who filed an annual confidential financial disclosure report last year should file a report this year. Also, the Department may require the 450 report from an employee who occupies a position on the exempt list but who performs duties that require a report in accordance with 5 C.F.R. 2634.904(a). Employees who are affected by this requirement will be notified on an individual basis. Further, the 450 report is required of all special Government employees, i.e., those who serve less than 130 days during any 365-day period, who are not SF 278 filers. Please direct any question about whether you are required to file the 450 report to your Administrative Officer. Also, if you think you might be required to file and do not receive the 450 form, contact your Administrative Officer. When to file: The 450 report must be completed, signed, and submitted between October 1 and October 31, 1996. These reports may NOT be submitted before October 1, 1996. Where to file: Unless otherwise instructed, Headquarters personnel should submit the completed and signed 450 report directly to the Office of the Assistant General Counsel for General Law, GC-80, Room 6A-211, Forrestal Building, and field personnel should submit the completed and signed 450 report directly to their respective field counsel.

The reporting period covered by the 450 report is the 12 months beginning on October 1, 1995, and ending on September 30, 1996. For example, in Part I of the 450 report you list all the reportable assets that you owned at any time during this 12-month period, even if you did not own the asset on September 30, 1996. If you sold or otherwise transferred the asset before October 1, 1996, check the box in the second column labeled "(X) if no longer held." Contents: The instructions on the 450 form answer most questions. Also, you may consult or copy the Review Guide, which your Administrative Officer has been provided. If you use the computer software, the "help" screens contain applicable portions of the Review Guide. The following information may be helpful to you in completing your report: Part I: Assets and Income -- list each asset that you, your spouse, or your dependent child(ren) owned at any time during the 12-month reporting period, that was held for investment or income and that had a fair market value of more than $1,000 on September 30, 1996 (or when sold) or produced more than $200 of income. Exclude your personal residence unless you received rent for part or all of it at some time during the reporting period. CANCELE D CANCELE D DOE N 326.3 3 9-30-96 Exclude your bank accounts or accounts in other depository financial institutions as well as money market accounts and funds; U.S. Government-backed securities; and U.S. obligations, such as Treasury bonds, bills, or notes, or U.S. Savings Bonds. (Disregard any instruction on the SF 450 to the contrary.) List the holdings in an IRA or 401(k) retirement account of you or your spouse. For a pension plan, identify the name of the sponsoring employer. If the pension plan is not independently managed (i.e., you or you spouse control the investment of the assets in the pension plan), list the underlying investments. Report each of your sources of earned income, including honoraria, that yielded more than $200 during the reporting period, except your employment with the Government. Report your spouse's employer(s) and other earned income that yielded more than $1,000 of income during the reporting period. Please designate your spouse's income and assets by placing an "S" under the number on that line. Part II: Liabilities -- list each debt that you, your spouse, or your dependent child(ren) owed to a single creditor that exceeded $10,000 at any time during the reporting period. Exclude the mortgage(s) on your home (unless you received rent from it) and secured automobile loan(s). Also, exclude credit card debt unless the balance on the credit card account exceeded $10,000 on September 30, 1996. Part III: Outside Positions -- list each position that you (but not your spouse or children) held during the reporting period, whether or not you were compensated for the position. Exclude positions with the U.S. Government or religious, fraternal, or political entities. Part IV: Agreements and Arrangements -- list each agreement or arrangement that you (but not your spouse or children) had during the reporting period regarding your future employment; any leave of absence; any severance or other continuing payments from a past employer; or any pension or employee benefit plan. Future employment includes full or part-time, consulting, writing, or teaching. Arrangements include unwritten understandings. Exclude any agreements or arrangements pertaining to your Federal employment.

Part V: Gifts and Travel Reimbursements -- list each source who provided you, your spouse, or your dependent child(ren) one or more gifts or travel reimbursements during the reporting period totaling more than $250 in fair market value, and describe briefly each gift or travel, including itinerary and dates. In computing the $250 aggregate amount, exclude each gift or travel reimbursement valued at $100 or less. Special Government employees are not required to complete this part. Common mistakes to avoid: Please check the "Annual Report" box on the first page. Where you have nothing to report on any one of the five Parts, check the "None" box for CANCELE D CANCELE D 4 DOE N 326.3 9-30-96 that Part. Do not write in "not applicable" or "N/A" . If you have a mutual fund to report, please provide the full name of each fund. Additional questions: Headquarters personnel may direct questions regarding completion of the 450 report to the Office of the Assistant General Counsel for General Law (202-586- 1522). Field personnel may address such questions to their respective field counsel. Exempted Positions: Employees who hold a contracting officer warrant or serve as a contracting officer's representative or contracting officer's technical representative are NOT exempt by this Notice from filing the 450 report. All other employees who occupy positions in the occupational series listed below in the specified grades are not required to file the 450 report. Positions at GS-15 or below in the following occupational series: 019 023 029 084 085 086 090 099 132 134 140 150 160 170 199 201 203 212 221 223 230 299 302 303 304 305 309 312 313 318 319 322 326 332 333 335 344 346 350 351 356 360 361 382 390 392 394 399 460 462 499 503 525 530 540 544 561 590 599 603 604 610 621 699 817 818 856 899 904 950 963 986 999 1016 1020 1060 1087 1099 1106 1107 1199 1202 1299 1316 1341 1371 1374 1399 1411 1420 1421 1499 1521 1531 1599 1670 1699 1702 1799 1999 2005 2030 2050 2099 2102 2132 2181 2199 2511 2604 2610 2619 2801 2805 2806 2808 2810 2843 3314 3502 3566 3603 4102 4204 4402 4414 4417 4605 4741 4742 4749 5003 5313 5324 5402 5407 5703 5716 5803 6907 CANCELE D CANCELE D DOE N 326.3 5 (and 6) 9-30-96 Positions at GS-14 or below in the following occupational series: 130 131 Positions at GS-13 or below in the following occupational series: 018 028 080 081 110 180 233 235 334 340 341 342 343 501 505 671 807 1410 1412 1510 1515 1520 1529 1530 1550 1712 2003 2010 Positions at GS-12 or below in the following occupational series: 020 101 246 260 301 345 385 386 391 393 401 403 404 408 415 430 440 480 482 486 560 601 602 690 802 806 808 809 905 930 1001 1015 1035 1071 1082 1083 1084 1101 1103 1104 1105 1140 1150 1152 1160 1163 1176 1220 1221 1222 1301 1306 1310 1311 1313 1315 1320 1321 1340 1350 1370 1372 1373 1601 1640 1654 1701 1910 2001 2101 2130 2131 2134 2150 2151 Positions at GS-11 or below in the following occupational series: 193 511 510 854 Positions at GS-9 or below in the following occupational series: 801 803 804 810 819 830 840 850 855 861 880 881 892 893 896 1102 1130 1170 1171 BY ORDER OF THE SECRETARY OF ENERGY: ARCHER L. DURHAM Assistant Secretary for Human Resources and Administration CANCELE D CANCELE D