Form 450 - Confidential Certificate Of No New Interests - U.s. Office Of Government Ethics Page 2
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2U.S. OFFICE OF GOVERNMENT ETHICS
OGE OPTIONAL FORM 450-A (08/2005)
____________________________________________________________________________________________________________________
Privacy Act Statement
Pursuant to Title I of the Ethics in Government Act of 1978 (5 U.S.C. App.) and Executive order 12674
(as modified by Executive Order 12731), the Office of Government Ethics regulations at 5 CFR Part 2634,
Subpart I, permit the completion of this Certificate of No New Interests in lieu of an annual OGE Form 450,
in appropriate cases.
The primary use of this form is for review by Government officials at your agency, to determine compliance
with applicable Federal conflict of interest laws and regulations. Additional disclosures of this certificate
may be made: (1) to a Federal, State, or local law enforcement agency, if the disclosing agency becomes
aware of a violation or potential violation of law or regulation; (2) to a court or party in a court or Federal
administrative proceeding, if the Government is a party or in order to comply with a judge-issued subpoena;
(3) to a source, when necessary to obtain information relevant to a conflict of interest investigation or decision;
(4) to the National Archives and Records Administration or the General Services Administration, in records
management inspections; (5) to the Office of Management and Budget during legislative coordination on
private relief legislation; (6) to the Department of Justice or in certain legal proceedings when the disclosing
agency, an employee of the disclosing agency, or the United States is a party to litigation or has an interest in
the litigation and the use of such records is deemed relevant and necessary to the litigation; (7) to reviewing
officials in a new office, department or agency when an employee transfers from one covered position to
another; (8) to a Member of Congress or a congressional office in response to an inquiry made on behalf of an
individual who is the subject of the record; and (9) to contractors and other non-Government employees
working for the Federal Government to accomplish a function related to an OGE Government-wide system of
records.
This Certificate of No New Interests is confidential. No member of the public shall have access to it,
except as authorized by law.
____________________________________________________________________________________________________________________
Penalties
Falsification of this certificate may subject you to disciplinary action by your employing agency or other authority.
Knowing and willful falsification of the certificate may also subject you to criminal prosecution.
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