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Below is the form and instructions for disclosing foreign gifts. Foreign gift forms should be filed with the Committee on Ethics, 1015 Longworth House Office Building. Forms must be filed within 60 days of accepting a tangible gift valued in excess of $390 from a foreign government, or within 30 days of accepting travel benefits from a foreign government.
POSITION OF REPORTING PERSON: Identify yourself as a Member, Officer, or employee of the House of Representatives. Employees should list their title and employing office.
RECIPIENT: Section 4(a) of the Regulations* includes the spouse and certain dependents of a Member, Officer, or employee of the House in the definition of Member, officer or employee of the House of Representatives.
DESCRIPTION OF GIFT(S): A brief description of the item is sufficient for disclosure purposes. Note that tangible gifts and decorations of more than minimal value are identified by the Regulations at 5(a) and 6(a) as those having a retail value in the United States of more than $375.
Describe in-kind gifts of travel, including food, lodging, transportation, and entertainment provided directly by a foreign government (as defined in 4(b)) to you, your spouse, or dependent(s).
Describe gifts of expenses for travel, including expenses for food, lodging, transportation and entertainment from a foreign government (as defined in 4(b)). Also describe in this item expenditures made by you for which you were reimbursed by a foreign government (as defined in 4(a)).
CIRCUMSTANCES JUSTIFYING ACCEPTANCE: Provide a brief description of the circumstances justifying acceptance of items described in preceding sections.
DATES OF ACCEPTANCE: For tangible gifts of more than minimal value, decorations of more than minimal intrinsic value, and expenses for travel, provide date of acceptance of each.
For gifts of travel or reimbursed expenses for travel, give inclusive dates travel occurred.
DONOR GOVERNMENT: Identify the donor governmental entity to the best of your knowledge.
ESTIMATED VALUE OF GIFT: Assistance in estimating value of tangible items may be obtained through the Clerk of the House of Representatives.
*Regulations promulgated by the Committee on Standards of Official Conduct [now Committee on Ethics] for the acceptance of decorations and gifts from foreign governments by Members, Officers, and employees of the House of Representatives, including travel or expenses for travel, are contained in the appendices to the House Ethics Manual,110th Congress, 2d Sess. (2008) at 389-393.