5 CFR Appendix B to Part 2634, Certificate of Compliance (Form Approved: OMB Control No. 3209-0007)

Appendix B to Part 2634 - Certificate of Compliance (Form Approved: OMB Control No. 3209-0007)

The Certificate of Compliance required by § 2634.408(d)(4) shall be executed as follows:

Certificate of Compliance

With respect to the qualified blind trust (qualified diversified trust) of___ (Settlor), the undersigned, the approved [Trustee] [___] of such trust, pursuant to 5 CFR 2634.405, has served in such fiduciary capacity during the calendar year [or for the period beginning___ and ending___] and is eligible to continue in such capacity by virtue of the following:

FIRST: The undersigned (and any director, officer, or employee) has not knowingly or negligently, and will not -

(A) disclose any information to an interested party with respect to the trust that may not be disclosed pursuant to title I of the Act, the implementing regulations (including 5 CFR 2634.408(d)(1)(i)), or the trust instrument;

(B) acquire any holding the ownership of which is prohibited by, or not in accordance with, applicable statute, regulation, or the terms of the trust instrument;

(C) solicit advice from any interested party with respect to such trust, which solicitation is prohibited by title I of the Act, the implementing regulations (including 5 CFR 2634.408(d)(1)(iii)), or the trust instrument;

(D) fail to file any document required by title I of the Act, the implementing regulations ( 5 CFR 2634.408), or the trust instrument; or

(E) violate or fail to comply with any provision or requirement of title I of the Act, the implementing regulations, or the trust instrument.

SECOND: The undersigned (and any director, officer, or employee) will not knowingly or negligently engage in the above-mentioned activities.

THIRD: The undersigned certifies that the statements contained herein are true, complete and correct to the best of such undersigned's knowledge and belief.

Date___

(firm)___

By:___

(title)___

Note:

See appendix C of this part for Privacy Act and Paperwork Reduction Act notices.

[ 57 FR 11830, Apr. 7, 1992; 57 FR 21855, May 22, 1992, as amended at 77 FR 39150, July 2, 2012]

This is a list of United States Code sections, Statutes at Large, Public Laws, and Presidential Documents, which provide rulemaking authority for this CFR Part.

This list is taken from the Parallel Table of Authorities and Rules provided by GPO [Government Printing Office].

It is not guaranteed to be accurate or up-to-date, though we do refresh the database weekly. More limitations on accuracy are described at the GPO site.


United States Code
U.S. Code: Title 5 - APPENDIX
U.S. Code: Title 26 - INTERNAL REVENUE CODE
U.S. Code: Title 28 - JUDICIARY AND JUDICIAL PROCEDURE
Statutes at Large
Presidential Documents

Executive Order ... 12674

Executive Order ... 12731

Title 5 published on 09-May-2017 03:44

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 5 CFR Part 2634 after this date.

  • 2017-05-18; vol. 82 # 95 - Thursday, May 18, 2017
    1. 82 FR 22735 - Technical Updating Amendments to Executive Branch Financial Disclosure and Standards of Ethical Conduct Regulations
      GPO FDSys XML | Text
      OFFICE OF GOVERNMENT ETHICS
      Final rule; technical amendments.
      Effective date: This final rule is effective May 18, 2017. Applicability date: The amendments to 5 CFR 2634.304 and 2634.907 are applicable as of January 1, 2017.
      5 CFR Parts 2634 and 2635