Certificate of Divestiture for ______________
To: _____________, Director
Departmental Ethics Office
From: Deputy DAEO
I am asking that you request that the Office of Government Ethics issue a Certificate of Divestiture pursuant to 26 U.S.C. 1043 to ____________________ so that he may receive favorable tax treatment on any gains he may realize from the sale of his stock holding in _____________.
Mr. _____________'s responsibilities include participation in the formulation of the Department's policy on _____________________. The companies in which Mr. _____________ owns stock are prominent participants in this area and could be affected by matters falling within Mr. __________'s responsibilities. Therefore, it is a reasonable necessity for divestiture to enable Mr. _______ to carry out his duties effectively.
Mr. ________ understands that the proceeds from the sale of the assets must be reinvested in an obligation of the U.S. Government or a diversified mutual fund as defined in 5 C.F.R. 2634.1003(c). The assets will be divested within three months of receiving the certificate.