For You

Part 3

Report your participation in any of the following agreements or arrangements during the reporting period:

• Future employment.
• Leaves of absence.
• Continuing payments from an employer, including severance and payments not yet received for previous work.  (This does not include ordinary salary from a current employer.)
• Continuing participation in an employee welfare, retirement, or other benefit plan, such as a pension or a deferred compensation plan.
• Retention or disposition of employer-awarded equity, sharing in profits, or carried interests (e.g., vested and unvested stock options, restricted stock, future share of a company’s profits, etc.)

Employer or Party:  Provide the party to the agreement or arrangement, other than yourself.  In most cases, the other party will be your employer.

City/State:  Provide the city and state of the other party.

Status and Terms:  Briefly describe the type of agreement or arrangement, its terms (in particular, the timing and form of any payments), and its current status.

Date:  Provide the month and year in which the agreement or arrangement began.  In many cases, this will be when you joined the employer or otherwise became eligible for coverage under the agreement or arrangement.

Agreements and Arrangements That Are Not Reportable

You do not need to report the following as agreements and arrangements in Part 3:

• Agreements and arrangements of your spouse or your dependent children.
• Agreements and arrangements with the United States Government, such as your participation in the Federal Employees Retirement System or the Civil Service Retirement System.
• If you are filing a Nominee, New Entrant, or Candidate report, any agreement or arrangement that will end before you file your report.