to be free in a free society. And I do not care how righteous the causes 416 if force is used to support them. Mr. BURSACH. Senator, it may be a matter of semantics, but this bill tato, "to require or attempt to require." I think that the word-or Byen to suggest-I think this would cover it more fully-suggest. Senator ERVIN. I think maybe the "request" may be a little more restrictive than the word "suggest." I had that in mind because I think when a man occupies a superior position and makes a request with respect to certain courses of action of one of his subordinates, as I stated before, that request is equivalent to command. I do not think there is any other way to characterize it. We will place in the record all of the questionnaire forms that have not been inserted in the record that relate to Internal Revenue Service employees. The forms referred to follow :) 1. Federal Government Employment.-List all other Federal agencies and other organizational segments of this Department or Agency in which you are presently employed. (Use an extra sheet of paper if needed.) If none, write NONE. 2. Non-Federal Employment.-Name all companies, firms, State or local Governinetal organizations, research organizations, and educational or other institutions you are serving as employee, officer, member, trustee, director, adviser or consultant, with or without compensation. (Use an extra sheet of paper if needed,) If none, write NONE. NAME AND KIND OF ORGANIZATION fe... marfacturing, research, insurance) LOCATION (City, State) (Statement continued on reverse) TITLE OR KIND OF POSITION STATEMENT OF EMPLOYMENT AND FINANCIAL INTERESTS (continued) AGENCY MAY INSERT OR OVERPRINT ADDITIONAL INSTRUCTIONS IN THE SPACE BELOW 3. Financial Interests.-Name of companies in which the consultant has any other financial interest, e.g. the ownership of securities or other interests which have a significant financial value. No need to reveal precise amounts of investments but give some indication of the nature of the financial interest or interests involved. NAME OF ORGANIZATION KIND OF ORGANIZATION NATURE OF INTEREST AND IN WHOSE NAME HELD I CERTIFY that the statements I have made are true, complete, and correct to the best of my knowledge and belief. I UNDERSTAND that if, during the period of my appointment, I undertake a new employment, I must promptly file an amended statement, and I must also report any new financial interests acquired during this period if required by the agency. CONFIDENTIAL STATEMENT OF EMPLOYMENT AND FINANCIAL INTERESTS 1 MAKE SE APPOINTEE TITLE OF POSITION 3. DATE OF APPOINTMENT 4. DEPARTMENT OR AGENCY PISTALE EMPLOYMENT AND FINANCIAL INTERESTS. List the names of all corporations, companies, firms, or other business enterprises, partnerships, non profit , and educational, or other institutions: (a) with which you are connected as an employee, officer, owner, director, member, trustee, partner, adviser, or consultant, five which you have any continuing financial interests, through a pension or retirement plan, shared income, or other arrangement as a result of any current or prior employment s of professional association. BAME & KIND OF ORGANIZATION. APPLICABLE.! ADDRESS POSITION IN ORGANIZATION NATURE OF FINANCIAL INTEREST ... PRIOR BUSINESS INCOME. TUSE PART I (D) DESIGNATIONS IF APPLICABLE PART I. C. List the names of all corporations, companies, firms, or other business enterprises, partnerships, nonprofit organizations, and educational, or other institutions in which you have any financial interest through the ownership of stock, stock options, bonds, securities, or other arrangements including trusts. NAME & KIND OF ORGANIZATION. HULE PART I DESIGNATION WHERE ADDRESS NATURE OF FINANCIAL EXTENT OF INTEREST (UNDER EXTENT OF INTEREST IF THE MOLDINGS IN THE COMPANY ARE UNDER $10 000 USE THE LETTER A. IF THE HOLDINGS ARE BETWEEN $10 000 AND 630.000 USE THE LETTER D. AND ABOVE $10.000, USE THE LETTERCI PART II. CREDITORS. List the names of your creditors other than those to whom you may be idebted by reason of a mortgage on property which you occupy as a personal residence or to whom you may be indebted for current and ordinary household and living expenses such as household furnishings, automobile, education, vacation, and similar expenses. NAME AND ADDRESS OF CREDITOR CHARACTER OF INDEBTEDNESS eg. PERSONAL LOAN. NOTE, SECURITY PART III. INTERESTS IN REAL PROPERTY. List your interest in real property or rights in lands, other than property which you occupy as a personal residence. NATURE OF INTEREST, e.g.. TYPE OF PROPERTY, e.g.. ADDRESS. IIP RURAL. GIVE RED. OR COUNTY AND STATEJ PART IV. INFORMATION REQUESTED OF OTHER PERSONS. If any information is to be supplied by other persons, e.g., attorney, accountant, relative, please indicate the name and address of such persons, the date upon which you requested that the information be supplied, and the nature of subject matter involved. Extra forms are enclosed for use by such persons. CONFIDENTIAL STATEMENT OF EMPLOMENT For use by an officer or employee as GENERAL REQUIREMENTS. The information to be furnished in this statement is required by Executive Order 11222 and the regulations of the Civil Service Commission issued thereunder and may not be disclosed except as the Commission or the agency head may determine for good cause shown. The Order does not require the submission of any information relating to an employee's connection with, or interest in, a professional society or a charitable, religious, social, fraternal, recreational, public service, civic, or political organization or any similar organization not conducted as a business enterprise and which is not engaged in the ownership or conduct of a business enterprise. Educational and other institutions doing research and development or related work involving grants of money from or contracts with the Government are deemed to be "business enterprises" for purposes of this report and should be included. The information to be listed does not require a showing of the specific amount of financial interest, indebtedness or the value of real property. In the event any of the required information, including holdings placed in trust, is not known to you but is known to another person, you should request that other person to submit the information on your behalf and should report such request in Part IV of your statement. The interest, if any, of a spouse, minor child, or other member of your immediate household shall be |