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U.S. HOUSE OF REPRESENTATIVES COMMITTEE ON ETHICS FINANCIAL DISCLOSURE GIFT DISCLOSURE WAIVER REQUEST This form should be used by any House Member, officer, or employee who is seeking a waiver of

How to fill out gift disclosure waiver request

How to Fill Out Gift Disclosure Waiver Request:

1. Download the gift disclosure waiver request form from the appropriate source, such as your employer's website or the relevant government agency.
2. Read the instructions carefully to understand the requirements and the purpose of the gift disclosure waiver request. Familiarize yourself with any specific guidelines or deadlines mentioned.
3. Fill out the personal information section accurately, including your full name, contact details, and any identification numbers required. Make sure to provide your current job title or position.
4. Specify the purpose of the gift disclosure waiver request. Explain why you are seeking a waiver and provide any necessary details or justifications. Be concise yet comprehensive in describing the circumstances surrounding the gift.
5. Clearly disclose the nature of the gift received or offered, including its estimated value, date of receipt, and the identity of the donor or recipient if applicable. If possible, attach any supporting documents, such as receipts or appraisal reports.
6. Acknowledge that you understand the potential conflicts of interest that may arise due to accepting or offering the gift, and explain how you plan to handle the situation responsibly. This may involve recusing yourself from relevant decision-making processes or seeking guidance from an ethics or compliance officer.
7. Sign and date the gift disclosure waiver request form. Make a copy of the completed form for your records, in case it is required in the future.

Who Needs Gift Disclosure Waiver Request:

1. Employees in positions of responsibility within an organization where conflicts of interest can arise due to accepting or offering gifts may need to fill out a gift disclosure waiver request. This often includes government officials, public servants, or individuals working in regulated industries.
2. Individuals who have received or offered a gift with a significant monetary value, or those who are unsure if a gift falls within disclosure requirements, should consider submitting a gift disclosure waiver request to ensure compliance with applicable laws and regulations.
3. Organizations or agencies that have specific policies or regulatory frameworks in place regarding the acceptance or offering of gifts may require their employees or members to fill out gift disclosure waiver requests as a standard practice.

Remember, it is crucial to consult your employer's or organization's policies, as well as any applicable laws or regulations, to determine if you need to fill out a gift disclosure waiver request and to ensure you accurately disclose all relevant information.

For pdfFiller’s FAQs

What is gift disclosure waiver request?

A gift disclosure waiver request is a form that allows an individual to request a waiver from disclosing certain gifts or items of value they have received.

Who is required to file gift disclosure waiver request?

Any individual who has received gifts or items of value that are required to be disclosed but believes they should be waived from disclosure may file a gift disclosure waiver request.

How to fill out gift disclosure waiver request?

To fill out a gift disclosure waiver request, the individual must provide personal information, details of the gift or item received, reasons why they believe the disclosure should be waived, and any supporting documentation.

What is the purpose of gift disclosure waiver request?

The purpose of the gift disclosure waiver request is to allow individuals to request exemptions from disclosing certain gifts or items of value they have received.

What information must be reported on gift disclosure waiver request?

The gift disclosure waiver request must include details of the gift or item received, the value of the gift, the relationship between the giver and recipient, and reasons for requesting the waiver.

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