SIMILAR TO FORM 709 SHOWN ABOVE EXCEPT
THAT THIS SHORTENED, SIMPLIFIED VERSION MAY BE FILED TO REPORT ONLY
CERTAIN SMALLER GIFTS OF PRESENT INTERESTS IN TANGIBLE PERSONAL
PROPERTY, CASH, OR STOCKS AND BONDS LISTED ON A STOCK EXCHANGE. USE
OF INFORMATION SIMILAR TO THAT SHOWN FOR FORM 709.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.