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II: OTHER INCOME (employee and spouse)

List the source and dollar amount of income from salaries, honoraria, publishing agreements, lecture fees, and other gainful activity which exceeded $100 from any one source for you, and list any source(s) from which your spouse received income that exceeded $1,000 from any one source. If your spouse is self-employed in a business or profession report only the nature of the business or profession. Report fees or any other income received, in addition to salary, from the Smithsonian or any of its affiliated units, and any other income not reported under Section I.

Exclude: Any noninvestment income of a child; earned income of your spouse that is less than $1,000 from a single source; salaries or wages paid by the Smithsonian [strike-through] of any United States federal, state or local government or entity; [\strike-through] [handwritten] SUGGESTED DELETION [\handwritten] and benefit payments from any government agency in the United States such as unemployment compensation or social security. 

[columns]
Source of Income [When indentifying employers give name of company, nature of business, and address]

[check box]'None'


Type of income (e.g., salary, honoraria fee, etc.)

"S" if income of spouse

$ Amount (Yours, not spouse's)

[/columns]

III(a). GIFTS (you, spouse, and dependent child)*

Report sources and amount of value of gifts, including any gifts of objects, where the total amount received from any single source exceeded $100.

Exclude: Any gift of a value of $35 or less (i.e., do not aggregate); gifts from your spouse or a dependent child; gifts or bequests from relatives; gifts to your spouse or dependent child if the gift was offered and received independently of any connection with you; and suitable mementos honoring you.
 
[columns]

Source (Name and Address)
Brief Description
Amount or Value

[check box] 'None'

[/columns]

III(b). HOSPITALITY (you, spouse, and dependent child)*

Report sources of lodging, transportation, food, and entertainment, where the total value received from any single source exceeded $250. Values need not be listed.
Exclude: Items or occasions valued at $35 or less; personal hospitality provided for nonbusiness reasons on premises owned or controlled by the provider; hospitality from relatives; or hospitality received by a spouse or dependent child independently of any connection or relationship with you.

[columns]

Source (Name and Address)
Brief Description

[check box] 'None'

[/columns]

III(c). REIMBURSEMENTS (you, spouse, and dependent child)*

Report source(s) of reimbursements for travel or other reimbursable activities where the aggregate amount received from any single source exceeded $250. Include reimbursements in connection with consulting activities or lecturing. Values need not be listed.

Exclude: Travel or other reimbursements received directly from an employer in the course of regular employment; reimbursement received by a spouse or dependent child if it was received independently of any connection with you.

[columns]

Source (Name and Address)
Brief Description
[check box] 'None'

[/columns]

*Consult the Smithsonian Standards of Conduct, or the Smithsonian Ethics Counselor, concerning gifts, hospitality, or reimbursement that might be improper even though they need not be reported.

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