Number range CHAPTER**SAMPLE - REQUEST FOR CONFLICT OF INTEREST WAIVER**

Director, **CIO,** or Assistant Administrator, ATSDR

Conflict of Interest Waiver

Carlton Duncan

Deputy Ethics Counselor, CDC/ATSDR

The purpose of this memorandum is to request that you grant **employee's
name** a waiver of the criminal conflict of interest provisions that may
apply to **his/her** service in an official capacity as an officer of an
outside non-profit organization. The need for a waiver is discussed
below.

The criminal conflict of interest statute, 18 U.S.C. § 208(a), requires
that an employee refrain from participating personally and substantially
in an official capacity in any particular matter that will have a direct
and predictable effect on the financial interests of any organization in
which the individual serves as an officer, director, trustee, or
employee.

In the absence of: (1) specific statutory authority placing a federal
employee in an officer or director position in an [ex
officio]{.underline} capacity, (2) a release of fiduciary obligations by
the organization (if permitted by state law), or (3) a waiver of the
requirements of section 208(a), the conflicts statute effectively would
preclude **his/her** service, as an official duty activity, as an
officer of the American Public Health Association (APHA).

APHA is the premiere public health professional association in the
country with over 30,000 members representing the broad spectrum of
public health at local, State, and national levels and academia; and
covering a wide variety of public health issues including training,
education, policy development, and leadership. The duty of the executive
board includes directing the administrative work of the association and
to coordinate and review recommendations of the various committees. APHA
receives most of its funding through membership dues, sale of
publications, conference registration fees, and private

foundation grants. It has on occasion sought and received federal grants
for specific projects. It has none from **CIO**. As an organization it
is a leader and spokesperson for public health issues. Through its
journals and publications it is a principle disseminator of scientific
information.

Inasmuch as **employee's name** election as a member of the executive
board of APHA is not pursuant to a statute or release of fiduciary
obligations, I am requesting that you, as the official responsible for
**his/her** appointment to a federal position, authorize **his/her**
participation in

Page 2 -- Carlton Duncan

certain particular matters that may affect the financial interests of
APHA. Under section 208(b)(1), a waiver may be granted if the selecting
official or delegatee determines that the disclosed financial interest
is \"not so substantial as to be deemed likely to affect the integrity
of the services which the Government may expect from \... \[the\]
employee.\" In the course of **his/her** assigned duties as **government
title,** the following types of particular matters potentially could
come before me for my personal and substantial participation: (1)
particular matters of general applicability, such as legislation,
regulations, or policy, that may affect the financial interest of APHA
as a member of a class of similarly situated entities; (2) matters that
affect one or more of the underlying holdings in the investment
portfolio of APHA; (3) particular matters involving specific parties
(specific party matters), such as grants, contracts, application
approvals, litigation, investigations, or enforcement actions, that
specifically involve APHA or otherwise affect its financial interest; or
(4) other miscellaneous matters involving the conduct of the
organization\'s affairs and Department support.

While performing, as an official duty activity, the usual and customary
duties of the position of an officer of an outside organization, any
actions taken, either in the federal workplace or at the organization,
that affect the financial interest of the outside organization are
deemed official matters to which section 208(a) may apply. For example,
such actions may include: (1) requesting that official travel funds be
spent or other government resources be utilized for the employee to
conduct the affairs of the organization; (2) signing a training
authorization to use agency funds to pay for a subordinate to attend a
seminar or other meeting of the organization; (3) speaking as an
official duty activity, or directing a subordinate to speak, at any
seminar or other meeting of the organization where attendance fees are
charged;

\(4\) participating as an official duty activity in fundraising
activities of the organization; or (5) providing advice and consultation
with respect to, or otherwise conducting, the business affairs of the
organization. While the financial impact of many of these particular
matters on an outside organization may be insignificant, under well
settled precedent, section 208(a) has no de minimis aspect.

Accordingly, if approved, the requested waiver will apply fully to the
employee\'s participation in an official capacity in any particular
matter that will directly and predictably affect the financial interest
of APHA, EXCEPT the following particular matters, as to which **he/she**
commits to recuse: discussions of any grant or contract under
consideration between APHA and **CIO**; and from serving as a
spokesperson for APHA in matters directly concerning HHS policy.

I believe that a waiver is justified for the following reasons: First,
because **employee's name** would serve in APHA as an assigned official
duty activity, there is a greatly diminished risk that the integrity of
the services that the Government expects would be affected. **His/her**
position in the outside organization is fully known to the agency.
Moreover, the agency already has determined that, to a significant
degree, the interests of the Department and the interests of APHA are
consonant; the agency expects that the interests of the Department and
the interests of APHA both can be furthered through the performance of
**his/her** official duties.

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Second, most if not all of the particular matters in which **employee's
name** would participate would not have a significant effect on the
financial interests of APHA. **He/she** will have no involvement in any
HHS grants, contracts or other financial support to the organization,
other than the use of Government travel or training funds, and will not
be involved in regulatory or investigatory matters having a significant
financial impact on APHA.

The employee understands and agrees that, as an official duty activity,
no separate compensation may be received from APHA in connection with
**his/her** service as its officer.

**NAME**

**DIRECTOR, CIO, or Asst. Admin., ATSDR**

DECISION:

Waiver granted, subject to the terms and conditions stated above, based
on my determination, made in accordance with 18 U.S.C. § 208(b)(1), that
the disclosed financial interests are not so substantial as to be deemed
likely to affect the integrity of the services which the Government may
expect from the employee.

Waiver denied.

Carlton Duncan Date

Acting Deputy Ethics Counselor

Confirmed and Acknowledged:

**EMPLOYEE'S NAME & TITLE** Date