OGE Form 278e: Part 6
Other Assets and Income

Introduction

Report assets and sources of investment income for you, your spouse, and your dependent children in Part 6. Do not include assets or income reported in Part 2 or Part 5 or earned income of your dependent child. Learn how to report a particular asset by selecting that asset from the table below.

Other Assets and Investment Income

If you have a type of asset or a source of investment income that is not listed above, click here for general guidance.

No Other Assets or Investment Income

If you do not have any other assets or sources of investment income to report, you need to state this fact. Within Integrity, you would make the statement by marking the “I do not have...” checkbox. For hard copy reports, write “None” for the first line entry.

American Depositary Receipt

Report an American depositary receipt (ADR) and income from the American depositary receipt in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Xylophone Technologies Corporation (XYZ)

N/A

$15,001 - $50,000

 

None (or less than $201)

2

Allgemeine Medikamente (pharmaceuticals), ADR

N/A

$15,001 - $50,000

dividends

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report an American depositary receipt if the value of the American depositary receipt was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the exact name of the American depositary receipt. In addition, if the security is not publicly traded in the United States, provide a description of the issuer’s trade or business and indicate that the security is an ADR. For publicly traded ADRs, it is helpful to provide the ticker symbol in addition to the name of the ADR.

EIF: Select “N/A.”

Value: Report the value of the American depositary receipt by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Annuity (fixed)

Report a fixed annuity and income from the annuity in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Mutual of Aurora, fixed annuity

N/A

$15,001 - $50,000

 

None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6

Report a fixed annuity if the value of the annuity was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period. Income is ordinarily reported when the annuity begins making payments.

Description: Provide the name of the insurance company issuing the annuity and write “fixed annuity.”

EIF: Select “N/A.”

Value: Report the value of the annuity by marking the appropriate category.

Income Type: If applicable, describe the type of income received as “cash payments” or “cash distributions.”

Income Amount: Provide the exact amount of income over $200 received during the reporting period. If you do not have such income to report, select the category for “None (or less than $201).”

Click Here for Frequently Asked Questions

 

Annuity (indexed)

Report an indexed annuity and income from the annuity in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Mutual of Aurora, indexed annuity, linked to S&P 500

N/A

$15,001 - $50,000

 

None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6

Report an indexed annuity if the value of the annuity was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period. Income is ordinarily reported when the annuity begins making payments.

Description: Provide the name of the insurance company issuing the annuity, write “indexed annuity,” and specify the name of the index to which the note is linked.

EIF: Select “N/A.”

Value: Report the value of the annuity by marking the appropriate category.

Income Type: If applicable, describe the type of income received as “cash payments” or “cash distributions.”

Income Amount: Provide the exact amount of income over $200 received during the reporting period. If you do not have such income to report, select the category for “None (or less than $201).”

Annuity (variable)

Report a variable annuity and income from the annuity in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Long Life, Inc., variable annuity

No

     

1.1

Liberty Income Securities Fund

Yes

$1,001 - $15,000

None (or less than $201)

1.2

American U.S. Large Cap Value Fund

Yes

$1,001 - $15,000

None (or less than $201)

1.3

Long Life Fixed Account

N/A

$1,001 - $15,000

None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6
Reporting the Overall Variable Annuity

Report a variable annuity if the total value of the annuity was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period. Income is ordinarily reported when the annuity begins making payments.

Description: Provide the name of the insurance company issuing the annuity and write “variable annuity.”

EIF: Select “No” because a variable annuity is an investment vehicle that does not qualify as an excepted investment fund.

Income Type: If applicable, describe the type of income received as “cash payments” or “cash distributions.”

Income Amount: Provide the exact amount of income received during the reporting period. If you do not have such income to report, leave this field blank.

Reporting the Underlying Assets

If the overall annuity is reportable, provide the names of each underlying asset within the annuity that individually was worth more than $1,000 at the end of the reporting period.

Description: Provide the name of the underlying asset.

EIF: For each underlying asset, indicate whether the asset (1) is an investment vehicle that qualifies as an EIF (“Yes”), (2) is an investment vehicle that does not qualify as an EIF (“No”), or (3) is not an investment vehicle that holds other assets (“N/A”).

Value: Report the value of the underlying asset by selecting the appropriate category.

Income Amount: Select the category for “None (or less than $201).”

Bond (corporate)

Report a corporate bond and income from the bond in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Xylophone Technologies Corporation, bonds

N/A

$15,001 - $50,000

interest

$201 - $1,000

2

Widgets Unlimited, bonds

N/A

None (or less than $1,001)

interest capital gains

$1,001 - $2,500

For You, Your Spouse, and Your Dependent Children

Part 6

Report a corporate bond if the value of the bond was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the name of the corporate issuer (e.g., “Xylophone Technologies Corporation”) and identify the asset as a bond. You do not need to include the terms of the bond.

EIF: Select “N/A.”

Value: Report the value of the bond by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Bonds normally produce interest income but may also produce capital gains if sold.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

Bond (municipal)

Report a municipal bond and income from the bond in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Philadelphia, PA, bonds

N/A

$15,001 - $50,000

interest

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report a bond if the value of the bond was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the name of the issuing government authority and identify the asset as a bond. You do not need to include the terms of the bond.

EIF: Select “N/A.”

Value: Report the value of the bond by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Bonds normally produce interest income but may also produce capital gains if sold.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

 

Brokerage Account

Report the underlying assets of a brokerage account in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

ABC Diversified Bond Fund (ABCDX)

Yes

$50,001 - $100,000

$1,001 - $2,500

2

Xylophone Technologies Corporation (XYZ)

N/A

None (or less than $1,001)

dividends capital gains

$2,501 - $5,000

or

#

Description

EIF

Value

Income Type

Income Amount

1

Brokerage account:

No

     

1.1

ABC Diversified Bond Fund (ABCDX)

Yes

$50,001 - $100,000

$1,001 - $2,500

1.2

Xylophone Technologies Corporation (XYZ)

N/A

None (or less than $1,001)

dividends capital gains

$2,501 - $5,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report each underlying asset of a brokerage account that individually was worth more than $1,000 at the end of the reporting period or from which more than $200 in income was received during the reporting period. You may indicate that the assets are held within a brokerage account, but this information is not required.

This guide contains specific instructions for common types of assets held within a brokerage account (e.g., mutual funds, exchange-traded funds, stocks, and corporate bonds).

Click Here for Frequently Asked Questions

 

 Business Development Corporation (BDC)

Report an equity interest (common shares or preferred stock) in a business development corporation (BDC) and income from the BDC in Part 6.

Business Development Corporation Qualifies as an EIF

#

Description

EIF

Value

Income Type

Income Amount

1

Positron Investments Corp. (POINV)

Yes

$100,001 - $250,000

 

$5,001 - $15,000

2

1201 Capital Ventures Corp., BDC

Yes

None (or less than $1,001)

 

$1,001 - $2,500

Business Development Corporation Does Not Qualify as an EIF – If you know the value of and income from the underlying assets

#

Description

EIF

Value

Income Type

Income Amount

1

1201 Capital Ventures Corp., BDC

No

     

1.1

Nutrodesign, LLC (agricultural products)

N/A

$15,001 - $50,000

None (or less than $201)

1.2

BMSL Propulsion, Inc. (rocket fuel research)

N/A

$15,001 - $50,000

None (or less than $201)

1.3

WQX Optics (medical devices)

N/A

$1,001 - $15,000

capital gains

$5,001 - $15,000

Business Development Corporation Does Not Qualify as an EIF – If you know the value of the underlying assets but the income from those assets is not readily ascertainable

#

Description

EIF

Value

Income Type

Income Amount

1

1201 Capital Ventures Corp., BDC

No

 

capital gains

$5,001 - $15,000

1.1

Nutrodesign, LLC (agricultural products)

N/A

$15,001 - $50,000

 

1.2

BMSL Propulsion, Inc. (rocket fuel research)

N/A

$15,001 - $50,000

 

1.3

WQX Optics (medical devices)

N/A

$1,001 - $15,000

 

 

Business Development Corporation Does Not Qualify as an EIF – If the value of and income from the underlying assets are not readily ascertainable

#

Description

EIF

Value

Income Type

Income Amount

1

1201 Capital Ventures, Corp., BDC

No

$50,001 - $100,000

capital gains

$5,001 - $15,000

1.1

Nutrodesign, LLC (agricultural products)

N/A

 

 

1.2

BMSL Propulsion, Inc. (rocket fuel research)

N/A

 

 

1.3

WQX Optics (medical devices)

N/A

 

 

For You, Your Spouse, and Your Dependent Children

Part 6

Report an equity interest in a business development corporation if the value was more than $1,000 at the end of the reporting period or if more than $200 in total income was received during the reporting period.

The reporting requirements will depend on whether the business development corporation qualifies as an excepted investment fund.

Business Development Corporation Qualifies as an EIF

Description: Provide the name of the business development corporation, and, unless it is clear from the name that you are reporting a BDC, describe the type of asset. For a publicly traded BDC, it is helpful to provide the ticker symbol in addition to the name.

EIF: Select “Yes.”

Value: Report the value of the fund by selecting the appropriate category.

Income Type: Leave this field blank.

Income Amount: Select the category that corresponds to the total amount of income received during the reporting period.

Business Development Corporation Does Not Qualify as an EIF

Description: Provide the name of the business development corporation, and, unless it is clear from the name that you are reporting a BDC, describe the type of asset. For a publicly traded BDC, it is helpful to provide the ticker symbol in addition to the name.

EIF: Select “No.”

Additional Disclosure of Underlying Assets: Because the business development corporation does not qualify as an EIF, you need to report each underlying asset of the business development corporation that was worth more than $1,000 at the end of the reporting period or from which more than $200 in income was received during the reporting period. Report each underlying asset using the guidance applicable to that type of asset.

For purposes of valuing an underlying asset in a business development corporation, you may use the value of the proportionate interest that you, your spouse, and your dependent children have in the underlying asset. For purposes of measuring income from an underlying asset, you may use the amount of income received from that underlying asset that is attributable to you, your spouse, and your dependent children.

In certain cases, investment funds do not provide information regarding an investor’s interest in the value and/or income of the business development corporation’s underlying assets. If you are unable to ascertain the value of the underlying assets, you may instead provide value information for the total interest that you, your spouse, and your dependent children have in the business development corporation. Similarly, if you are unable to ascertain the income from the underlying assets, you may instead provide income information for the total interest that you, your spouse, and your dependent children have in the business development corporation.

 

Business Development Corporation (BDC) Bond/Note

Report a bond/note issued by a business development corporation (BDC) and income from the bond/note in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Positron Investments Corp., note

N/A

$100,001 - $250,000

 

$5,001 - $15,000

2

1201 Capital Ventures Corp., note

N/A

None (or less than $1,001)

interest capital gains

$1,001 - $2,500

For You, Your Spouse, and Your Dependent Children

Part 6

Report a bond/note issued by a business development corporation if the value of the bond/note was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the name of the business development corporation (e.g., “Positron Investments Corp.”) and identify the asset as a bond/note. You do not need to include the terms of the bond or the ticker symbol; however, including the ticker symbol for traded bonds/notes is helpful.

EIF: Select “N/A.”

Value: Report the value of the bond/note by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Bonds/notes normally produce interest income but may also produce capital gains if sold.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

 

Cash Account

Report a cash account and income from the cash account in Part 6.

Note: Virtual currency and accounts holding virtual currency should not be treated as “cash accounts”; rather, please see the entry for virtual currency in this guide.

#

Description

EIF

Value

Income Type

Income Amount

1

U.S. bank #1 (cash)

N/A

$100,001 - $250,000

interest

$201 - $1,000

2

U.S. bank #2 (cash)

N/A

$15,001 - $50,000

None (or less than $201)

3

U.S. brokerage money market account (cash)

N/A

$50,001 - $100,000

interest

$201 - $1,000

4

U.S. credit union (cash)

N/A

$1,001 - $15,000

None (or less than $201)

5

1st Bank of France (cash)

N/A

$50,001 - $100,000

interest

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6

Aggregate all of the cash accounts at a single financial institution that belong to you, your spouse, or your dependent children. Report the cash accounts if the total value of the accounts was more than $5,000 at the end of the reporting period or if more than $200 in total income was received during the reporting period. Note that the value threshold for cash accounts is higher than that of other assets.

Description: For accounts held at a bank, credit union, or other similar financial institution in the United States, identify that the account is a cash account held in the United States and identify the type of financial institution. For accounts held in U.S. financial institutions, you may provide the name of the financial institution but do not have to do so. You must have an entry for each U.S. financial institution where there are reportable accounts. If you have accounts at multiple financial institutions, identify the accounts as “U.S. bank #1 (cash)” and “U.S. bank #2 (cash)” and so on.

For an account held at a foreign bank or financial institution, write the name of the bank and indicate that it is a cash account.

Do not provide account numbers for any cash account.

EIF: Select “N/A.”

Value: Report the value of the account(s) by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. The type of income is usually “interest” for bank accounts.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

Collectible Item

Report a collectible item and income from a collectible item in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Collection of “Star Wars” figures

N/A

None (or less than $1,001)

capital gains

$201 - $1,000

2

Artwork

N/A

$500,001 - $1,000,000

capital gains

$50,001 - $100,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report a collectible item if

(1) the item is held for investment purposes and had a value that was more than $1,000 at the end of the reporting period 

or

(2) the item was a source of more than $200 in income received during the reporting period.

Description: Describe the nature of the collectible item, such as “rare book” or “classic car.” You may aggregate multiple items of a similar nature as a single entry.

EIF: Select “N/A.”

Value: Report the value of the collectible item by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

 

College Savings Plan (529 plan)

Report a college savings plan and income from the plan in Part 6.

Assets within a College Savings Plan – No distributions yet

#

Description

EIF

Value

Income Type

Income Amount

1

CA (ScholarShare) College Savings Plan

No

     

1.1

Active 5-8 Years

Yes

$1,001 - $15,000

None (or less than $201)

1.2

Aggressive Growth

Yes

$1,001 - $15,000

None (or less than $201)

Assets within and Distributions from a College Savings Plan

#

Description

EIF

Value

Income Type

Income Amount

1

CA (ScholarShare) College Savings Plan

No

 

cash distributions

$15,025

1.1

Active 5-8 Years

Yes

$1,001 - $15,000

 

None (or less than $201)

1.2

Aggressive Growth

Yes

$1,001 - $15,000

None (or less than $201)

Final Distribution from a College Savings Plan – No remaining assets

#

Description

EIF

Value

Income Type

Income Amount

1

New Hampshire UNIQUE College Investing (529) Plan, no remaining assets

N/A

 

cash distribution

$7,857

For You, Your Spouse, and Your Dependent Children

Part 6
Reporting the Overall Plan

Report a college savings plan if the total value was more than $1,000 at the end of the reporting period or if more than $200 in total distributed income was received during the reporting period. Income is ordinarily reported when funds are withdrawn.

Description: Provide the sponsoring state and the type of plan. If the plan has no remaining assets, note that as well.

EIF: If the plan has underlying assets (e.g., you have selected portfolio options, such as the Target 2024 Portfolio), select “No.” If the plan no longer has underlying assets and you are reporting only distributed income during the reporting period, mark this field as “N/A.”

Income Type: If applicable, describe the type of income received as “cash payments” or “cash distributions.”

Income Amount: Provide the exact amount of income received during the reporting period. If you do not have such income to report, leave the field blank.

Reporting the Underlying Assets

If the overall plan is reportable, provide the names of each underlying asset within the plan that individually was worth more than $1,000 at the end of the reporting period.

Description: Provide the name of the underlying asset, which is typically the name of a portfolio or fund.

EIF: For each underlying asset, indicate whether the asset (1) is an investment vehicle that qualifies as an EIF (“Yes”), (2) is an investment vehicle that does not qualify as an EIF (“No”), or (3) is not an investment vehicle that holds other assets (“N/A”). In most cases, the underlying assets will qualify as EIFs.

Value: Report the value of the underlying asset by selecting the appropriate category.

Income Type: Leave this field blank.

Income Amount: Select the category for “None (or less than $201).”

Click Here for Frequently Asked Questions

Common Trust Fund of a Bank

Report a common trust fund of a bank and income from the common trust fund in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

First District Bank, Long-Term Bond Common Trust Fund

Yes

$15,001 - $50,000

 

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report a common trust fund if the value of the common trust fund was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Normally, a common trust fund of a commercial bank that is open to the public will qualify as an excepted investment fund (EIF). In that case, report this item as follows:

Description: Provide the name of the bank and the common trust fund.

EIF: Select “Yes.”

Value: Report the value of the common trust fund by selecting the appropriate category.

Income Type: Do not complete this field for EIFs.

Income Amount: Select the category that corresponds to the total amount of income received during the reporting period.

Donor-Advised Fund

You do not need to report in Part 6 a donor-advised fund that is available from an established U.S. financial institution.

Donor-Advised funds have the following criteria:

  • The donor-advised fund’s sponsoring organization is registered with the IRS as a 501(c)(3) charitable organization.
  • Your donations are irrevocable.
  • You retain no ownership interest in the gift or the fund.
  • You retain no income interest in the gift or the fund (i.e., any post-donation capital gains, dividends, interest, etc., belong irrevocably to the fund and not to you).
  • You receive no continuing economic benefit resulting from the contribution or management of your donation other than the current year tax deduction for a charitable contribution.
  • Although you may retain the “privilege” of recommending a target charity for donation distribution, the fund retains ultimate control over this decision and your recommendation is nonbinding.
  • Although you may retain the “privilege” of providing a nonbinding recommendation for allocation or re-allocation of donated account assets, the fund retains ultimate control over this decision.

For purposes of the above criteria, “you” also includes your spouse and dependent children. If these criteria are not met, contact an ethics official for further guidance.

Click Here for Frequently Asked Questions

Equity Index-Linked Note

Report an equity index-linked note and income from the note in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

First District Bank Note Linked to S&P 500 Index

N/A

$1,001 - $15,000

 

None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6

Report an equity index-linked note if the value of the note was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the name of the issuer and the name of the index to which the note is linked.

EIF: Select “N/A.”

Value: Report the value of the note by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Equity index-linked notes normally produce interest income but may also produce capital gains if sold.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Exchange-Traded Fund (ETF)

Report an exchange-traded fund (ETF) and income from the fund in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

iShares Dow Jones U.S. Industrial Sector Index Fund (IYJ)

Yes

$15,001 - $50,000

 

$201 - $1,000

2

iShares Dow Jones U.S. Energy Sector Index Fund (IYE)

Yes

None (or less than $1,001)

 

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report an exchange-traded fund if the value of the fund was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the exact name of the fund (e.g., list “iShares S&P 500 Index” rather than just “iShares”). Providing the ticker symbol is also helpful.

EIF: Select “Yes.”

Value: Report the value of the fund by selecting the appropriate category.

Income Type: Do not complete this field for EIFs.

Income Amount: Select the category that corresponds to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

 

Exchange-Traded Note (ETN)

Report an exchange-traded note (ETN) and income from the note in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

iPath S&P GSCI Crude Oil Total Return Index ETN (OIL)

N/A

$15,001 - $50,000

interest

$201 - $1,000

2

JP Morgan Alerian MLP Index ETN (AMJ)

N/A

None (or less than $1,001)

interest capital gains

$1,001 - $2,500

For You, Your Spouse, and Your Dependent Children

Part 6

Report an exchange-traded note if the value of the note was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the exact name of the exchange-traded note (e.g., list “iShares S&P 500 Index ETN” rather than just “iShares”). Providing the ticker symbol is also helpful.

EIF: Select “N/A.”

Value: Report the value of the note by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Exchange-traded notes normally produce interest income but may also produce capital gains if sold.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Farm (or farmland)

Report a passive investment interest in a farm or farmland in Part 6.

Do not use these instructions if you have or your spouse has an active management role in the farm. Report a farm that you manage as a business in Part 2, and report a farm that your spouse manages in Part 5.

#

Description

EIF

Value

Income Type

Income Amount

1

Bar T Farm, Keller, TX,corporate stock holder (livestock)

N/A

$1,001 - $15,000

dividends

$201 - $1,000

2

Farmland, Zanesville, OH, leased for cash rent

N/A

$250,001 - $500,000

rent or royalties

$15,001 - $50,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report a passive investment interest in a farm or farmland if the value of the interest was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description:

(1) Farm: Provide the name of the farm; the location of the farm (either the city and state or the county and state); the business of the farm, such as crops or livestock; and, if applicable, an indication that the farm has been leased to a third party. In addition, it is helpful if you specify the type of interest that you have in the farm.

(2) Farmland: Identify the interest as farmland and provide its location (either the city and state or the county and state). In addition, if applicable, provide the name of the partnership or other entity used to hold the farmland and note any leasing arrangements.

EIF: Select “N/A.”

Value: Report the value of your interest by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount:

(1) Income less than $201: Select the category for “None (or less than $201).”

(2) Dividends, capital gains, interest, rent, or royalties: Select the category that corresponds to the total amount of income received during the reporting period.

(3) Other income: Provide the exact amount of income received during the reporting period.

Click Here for Frequently Asked Questions

 

Foreign Exchange Position (“forex”)

Report a foreign exchange position and income from the foreign exchange position in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Euro-U.S. Dollar (EUR/USD), open position

N/A

$1,001 -$15,000

 

None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6

Report a foreign exchange position if the value of the position was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the name of the foreign exchange position by identifying the currency pair (e.g., “U.S. Dollar-Japanese Yen”) and indicate whether the position is open or closed.

EIF: Select “N/A.”

Value: Report the value by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

 

Futures Contract (“future”)

Report a futures contract (or “future”) and income from the future in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Crude oil futures, closed position

N/A

None (or less than $1,001)

capital gains

$1,001 - $2,500

2

Pork belly futures, open position

N/A

$1,001 - $15,000

None (or less than $201)

3

Silver futures, open position (value not readily ascertainable): December 2022, 10 contracts, $32.20/oz.

N/A

 

None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6

Report futures if the value of the future was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the name of the future and indicate whether the position is open or closed.

EIF: Select “N/A.”

Value: Report the value by selecting the appropriate category. If the value of the future is difficult to determine, write “value not readily ascertainable” in the “Description” field and provide the following information: (1) the contract month and year; (2) the number of contracts you control; and (3) the closing price of the future.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

Government Agency or GSE Security

Report a Government agency or Government-Sponsored Enterprise (GSE) security and income from the security in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

GNMAs

N/A

$15,001 - $50,000

interest

$201 - $1,000

2

Fannie Mae

N/A

$15,001 - $50,000

interest

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report a Government agency or GSE security if the value of the security was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the name of the issuer. You do not need to include the terms of the security.

EIF: Select “N/A.”

Value: Report the value of the security by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Health Savings Account (HSA)

A Health Savings Account does not need to be reported unless you receive over $200 of income from it in the reporting period or if it has a balance of over $1000 at the end of the reporting period. If a Health Savings Account has a value of over $1000, report the underlying assets of a health savings account in Part 6. A health savings account held in connection with employment may instead be reported in Part 2 or Part 5. If you received over $200 in income from the account, report the income. If you do not know how much of a distribution is income, as opposed to a return of your contributions, you can report the total distributions in lieu of income.

Health Savings Account - Cash only with income less than $201

#

Description

EIF

Value

Income Type

Income Amount

1

HSA: U.S. bank #1 (cash)

N/A

$1,001 - $15,000

 

None (or less than $201)

Health Savings Account - Cash only reporting distributions instead of income

#

Description

EIF

Value

Income Type

Income Amount

1

HSA: U.S. bank #1 (cash)

N/A

$1,001 - $15,000

cash distribution

$850

Health Savings Account - Assets with income less than $201

#

Description

EIF

Value

Income Type

Income Amount

1

HSA:

No

     

1.1

ABC Diversified Bond Fund

Yes

$50,001 - $100,000

 None (or less than $201)

1.2

Xylophone Technologies Corporation (XYZ)

N/A

$1,001 - $15,000

 None (or less than $201)

Health Savings Account - Assets reporting distributions instead of income

#

Description

EIF

Value

Income Type

Income Amount

1

HSA:

No

 

cash distributions

$850

1.1

ABC Diversified Bond Fund

Yes

$50,001 - $100,000

 

 None (or less than $201)

1.2

Xylophone Technologies Corporation (XYZ)

N/A

$1,001 - $15,000

 

 None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6
Reporting Assets within a Health Savings Account

Report each underlying asset of your health savings account that individually was worth more than $1,000 at the end of the reporting period. Indicating that the assets are held within a health savings account will help explain the income figures provided; however, this indication is not required.

This guide contains specific instructions for common types of assets held within a health savings account (e.g., cash, mutual funds, exchange-traded funds, stocks, and corporate bonds).

Note that OGE does not treat tax-deferred income accruing within a health savings account as having been received because of the limitations on withdrawal and other regulatory requirements governing such accounts. You, however, would report distributions as having been received. See below.

Reporting Distributed Income from a Health Savings Account

If you had more than $200 in income in your health savings account, report the total amount of distributed income. Report the distribution as part of the entry for the overall account.

Description: Health savings account. In addition, if the account has no remaining assets, add “no remaining assets” to the description.

EIF: Select “N/A.”

Income Type: Describe the type of income as “cash distributions” or “cash payments.”

Income Amount: Provide the amount of income received or distributed during the reporting period.

Investment Club

Report an investment club and its underlying assets in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Odds and Ends Investors (investment club)

No

     

1.1

Nutrodesign, LLC (agricultural products)

N/A

$15,001 - $50,000

None (or less than $201)

1.2

BMSL Propulsion, Inc. (rocket fuel research)

N/A

$15,001 - $50,000

None (or less than $201)

1.3

WQX Optics (medical devices)

N/A

$1,001 - $15,000

capital gains

$5,001 - $15,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report an equity interest in an investment club if the value was more than $1,000 at the end of the reporting period or if more than $200 in total income was received during the reporting period.

An investment club very rarely qualifies as an excepted investment fund.

Description: Provide a name of the investment club, and, unless it is clear that you are reporting an investment club, describe the type of asset.

EIF: Select “No” for the fund.

Additional Disclosure of Underlying Assets: Because the investment club likely does not qualify as an EIF, you need to report each underlying asset of the club that was worth more than $1,000 at the end of the reporting period or from which more than $200 in income was received during the reporting period. Report each underlying asset using the guidance applicable to that type of asset.

For purposes of valuing an underlying asset in a fund, you may use the value of the proportionate interest that you, your spouse, and your dependent children have in the underlying asset. For purposes of measuring income from an underlying asset, you may use the amount of income received from that underlying asset that is attributable to you, your spouse, and your dependent children.

Investment Fund (general)

Report an equity interest in an investment fund and income from the fund in Part 6.

Note that other entries in this guide specifically address business development corporations, mutual funds, exchange-traded funds, and money market funds. See those entries for more targeted guidance if applicable.

Investment Fund Qualifies as an EIF

#

Description

EIF

Value

Income Type

Income Amount

1

Positron Investments XI, LP

Yes

$100,001 - $250,000

 

$5,001 - $15,000

Investment Fund Does Not Qualify as an EIF – If you know the value of and income from the underlying assets

#

Description

EIF

Value

Income Type

Income Amount

1

1201 Capital Ventures Fund, LLC

No

     

1.1

Nutrodesign, LLC (agricultural products)

N/A

$15,001 - $50,000

None (or less than $201)

1.2

BMSL Propulsion, Inc. (rocket fuel research)

N/A

$15,001 - $50,000

None (or less than $201)

1.3

WQX Optics (medical devices)

N/A

$1,001 - $15,000

capital gains

$5,001 - $15,000

Investment Fund Does Not Qualify as an EIF – If you know the value of the underlying assets but the income from those assets is not readily ascertainable

#

Description

EIF

Value

Income Type

Income Amount

1

1201 Capital Ventures Fund, LLC

No

 

capital gains

$5,001 - $15,000

1.1

Nutrodesign, LLC (agricultural products)

N/A

$15,001 - $50,000

 

1.2

BMSL Propulsion, Inc. (rocket fuel research)

N/A

$15,001 - $50,000

 

1.3

WQX Optics (medical devices)

N/A

$1,001 - $15,000

 

 

Investment Fund Does Not Qualify as an EIF – If the value of and income from the underlying assets are not readily ascertainable

#

Description

EIF

Value

Income Type

Income Amount

1

1201 Capital Ventures Fund, LLC

No

$50,001 - $100,000

capital gains

$5,001 - $15,000

1.1

Nutrodesign, LLC (agricultural products)

N/A

 

 

1.2

BMSL Propulsion, Inc. (rocket fuel research)

N/A

 

 

1.3

WQX Optics (medical devices)

N/A

 

 

For You, Your Spouse, and Your Dependent Children

Part 6

Report an equity interest in an investment fund if the value was more than $1,000 at the end of the reporting period or if more than $200 in total income was received during the reporting period.

The reporting requirements will depend on whether the investment fund qualifies as an excepted investment fund.

Investment Fund Qualifies as an EIF

Description: Provide the name of the investment fund and, unless it is clear from the name that you are reporting a fund, describe the type of asset.

EIF: Select “Yes.”

Value: Report the value of the fund by selecting the appropriate category.

Income Type: Leave this field blank.

Income Amount: Select the category that corresponds to the total amount of income received during the reporting period.

Investment Fund Does Not Qualify as an EIF

Description: Provide the name of the investment fund and, unless it is clear that you are reporting a fund, describe the type of asset.

EIF: Select “No” for the fund.

Additional Disclosure of Underlying Assets: Because the investment fund does not qualify as an EIF, you need to report each underlying asset of the fund that was worth more than $1,000 at the end of the reporting period or from which more than $200 in income was received during the reporting period. Report each underlying asset using the guidance applicable to that type of asset.

For purposes of valuing an underlying asset in a fund, you may use the value of the proportionate interest that you, your spouse, and your dependent children have in the underlying asset. For purposes of measuring income from an underlying asset, you may use the amount of income received from that underlying asset that is attributable to you, your spouse, and your dependent children.

In certain cases, investment funds do not provide information regarding an investor’s interest in the value and/or income of the fund’s underlying assets. If you are unable to ascertain the value of the underlying assets, you may instead provide value information for the total interest that you, your spouse, and your dependent children have in the fund. Similarly, if you are unable to ascertain the income from the underlying assets, you may instead provide income information for the total interest that you, your spouse, and your dependent children have in the fund.

Click Here for Frequently Asked Questions

 

Life Insurance (term)

Do not report a term life insurance policy that belongs to you, your spouse, or dependent child. In addition, do not report proceeds received from a term life insurance policy for which you, your spouse, or dependent child is a beneficiary.

Life Insurance (variable)

Report a variable life insurance policy and income from the policy in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Long Life, Inc., variable life

No

     

1.1

Liberty Income Securities Fund

Yes

$1,001 - $15,000

None (or less than $201)

1.2

American U.S. Large Cap Value Fund

Yes

$1,001 - $15,000

None (or less than $201)

1.3

Long Life Fixed Account

N/A

$1,001 - $15,000

None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6

Report a variable life insurance policy if the total value of the policy was more than $1,000 at the end of the reporting period or if more than $200 in total income was received during the reporting period. In addition, provide the names of each underlying holding within the policy that individually was worth more than $1,000 at the end of the reporting period. Income is ordinarily reportable only if also reportable for tax purposes.

Reporting the Overall Variable Life Insurance Policy

Description: Provide the name of the insurance company issuing the policy and write “variable life.”

EIF: Select “No” for the first line entry of a variable life policy because the overall policy is an investment vehicle that does not qualify as an excepted investment fund.

Income Type: If applicable, report the type of income received from the policy during the reporting period.

Income Amount:

(1) Income less than $201: Leave this field blank.

(2) Dividends, capital gains, interest, rent, or royalties: Select the category that corresponds to the total amount of income received during the reporting period.

(3) Other income: Provide the exact amount of income received during the reporting period.

Reporting the Underlying Assets

Description: Provide the name of the underlying asset.

EIF: For each underlying asset, indicate whether the asset (1) is an investment vehicle that qualifies as an EIF (“Yes”), (2) is an investment fund that does not qualify as an EIF (“No”), or (3) is not an investment vehicle that holds other assets (“N/A”). In most cases, an investment fund held within a variable life insurance policy will qualify as an EIF.

Value: Report the value of the underlying asset by selecting the appropriate category.

Income Amount: Select the category for “None (or less than $201).”

Click Here for Frequently Asked Questions

 

Life Insurance (whole or universal)

Report a whole or universal life insurance policy and income from the policy in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Home Life, Inc., whole life

N/A

$15,001 - $50,000

 

None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6

Report a whole life or universal life insurance policy if the value of the policy was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period. Income is ordinarily reportable only if also reportable for tax purposes.

Description: Provide the name of the insurance company issuing the policy and write “whole life” or “universal life.”

EIF: Select “N/A.”

Value: Report the value of the policy by selecting the appropriate category.

Income Type: If applicable, report the type of income received from the policy during the reporting period.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

 

Loan Made to Another Party

Report a loan that you, your spouse, or your dependent child made and the income from such a loan in Part 6. However, you do not need to report loans to certain members of your immediate family, as discussed below.

#

Description

EIF

Value

Income Type

Income Amount

1

Loan to family member

N/A

$1,001 - $15,000

 

None (or less than $201)

2

Loan to Family Trust #1

N/A

$50,001 - $100,000

interest

$201 - $1,001

3

Loan to Ms. Kowalski

N/A

$15,001 - $50,000

None (or less than $201)

4

Note from Brain Imagery Consultations, LLC

N/A

$50,001 - $100,000

interest

$1,001 - $2,500

For You, Your Spouse, and Your Dependent Children

Part 6

The applicable statute excludes certain loans to family members from the reporting requirement. You do not need to report personal loans made by you, your spouse, or a dependent child to a parent, spouse, sibling, or child.

Report a loan made to another party if the value of the loan was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period. The other party may be either a person or an entity.

Description: Identify the party who owes the liability and write “loan” or “note.” If the party is a family member, you may identify the party as a “family member” (e.g., “loan to a family member”). If the party is a natural person (i.e., a human) who is not related to you, identify the party by last name only (e.g., “loan to Ms. Kowalski”). If the trust is for the benefit of you or family members, you may use initials in lieu of a person’s name (e.g., “2003 J.S. Trust”) or simply refer to the entity as a family trust (e.g., “Family Trust #1”). If the party is another entity, identify the party by name (e.g., “loan to Wilson Widgets”).

EIF: Select “N/A.”

Value: Report the value of the loan by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Loans normally produce interest income.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

Managed Account

Report the underlying assets of a managed account in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

ANW Wealth Retention Strategy (ANW Investment, Inc.):

No

     

1.1

ABC Diversified Bond Fund (ABCDX)

Yes

$50,001 - $100,000

$1,001 - $2,500

1.2

Xylophone Technologies Corporation (XYZ)

N/A

None (or less than $1,001)

dividends capital gains

$2,501 - $5,000

or

#

Description

EIF

Value

Income Type

Income Amount

1

ABC Diversified Bond Fund (ABCDX)

Yes

$50,001 - $100,000

 

$1,001 - $2,500

2

Xylophone Technologies Corporation (XYZ)

N/A

None (or less than $1,001)

dividends capital gains

$2,501 - $5,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report each underlying asset of a managed account that individually was worth more than $1,000 at the end of the reporting period or from which more than $200 in income was received during the reporting period. Although this information is not required, it is helpful if you also provide the name of the managed account.

This guide contains specific instructions for common types of assets held within a managed account (e.g., mutual funds, exchange-traded funds, stocks, and corporate bonds).

A Managed Account Is Not an “Excepted Investment Fund”

Note that your managed account is not an “excepted investment fund.” Even if you selected an established portfolio of investment choices when you established your managed account, the managed account is not an “excepted investment fund.” In fact, the managed account is not an investment fund at all. You have not “pooled” your money with other investors. Although the account manager may have offered you the option of selecting a predetermined “portfolio” of assets, you own each of these assets individually and directly in your own name. For this reason, as well as other reasons, disclose each asset as a separate line item in your financial disclosure report.

Click Here for Frequently Asked Questions

 

Master Limited Partnership (MLP)

Report a master limited partnership (MLP) and income from a MLP in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Texas Pipeline MLP (TEXP)

N/A

$50,001 - $100,000

dividends

$2,501 - $5,000

2

Transline Ventures MLP (oil and gas)

N/A

None (or less than $1,001)

capital gains

$1,001 - $2,500

For You, Your Spouse, and Your Dependent Children

Part 6

Report a master limited partnership if the value of the master limited partnership was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the exact name of the master limited partnership (e.g., “Texas Pipeline MLP”). In addition, for a private master limited partnership, identify the area of concentration. For publicly traded master limited partnerships, it is helpful to provide the ticker symbol in addition to the name of the master limited partnership.

EIF: Select “N/A.”

Value: Report the value of the master limited partnership by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

 

Money Market Fund (MMF)

Report a money market fund and income from the fund in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Vanguard Prime Money Market Fund (VMMXX)

Yes

$15,001 - $50,000

 

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report a money market fund if the value of the fund was more than $5,000 at the end of the reporting period or if more than $200 in income was received during the reporting period. Note that the value threshold for money market funds is higher than that of other assets.

Description: Provide the exact name of the fund (e.g., write “Vanguard Prime Money Market Fund”; do not write only “Vanguard” or “Vanguard money market fund”). Providing the ticker symbol is also helpful.

EIF: Select “Yes.”

Value: Report the value of the fund by selecting the appropriate category.

Income Type: Do not complete this field for EIFs.

Income Amount: Select the category that corresponds to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

 

Mutual Fund

Report a mutual fund and income from the fund in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Janus Balanced Fund (JDBAX)

Yes

$15,001 - $50,000

 

$201 - $1,000

2

ABC Healthcare Fund (ABCHX)

Yes

None (or less than $1,001)

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report a mutual fund if the value of the fund was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the exact name of the fund (e.g., write “Janus Balanced Fund”;
do not write only “Janus” or “Balanced Fund”). Providing the ticker symbol is also helpful.

EIF: Select “Yes.”

Value: Report the value of the fund by selecting the appropriate category.

Income Type: Do not complete this field for EIFs.

Income Amount: Select the category that corresponds to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

 

Non-Fungible Token (NFT) (Collectible or Fractionalized)

Report a collectible non-fungible token (NFT) or fractionalized non-fungible token (F-NFT) in Part 6, unless it is held in connection with employment, in which case it should be reported in Part 2 or Part 5.

Note: The following guidance applies to NFTs and F-NFTs that represent a virtual item or a collectible, such as digital artwork, music, video files, trading cards, or items for use and/or display in a virtual environment (e.g., your avatar’s jacket in an online game). For NFTs and F-NFTs that represent other types of interests (for example, NFTs, that replicate stock equity, represent an investment in equity or debt pool, or represent ownership of physical assets), consult an ethics official at your agency.

#

Description

EIF

Value

Income Type

Income Amount

1

“Hieroglyph” NFT (MetaMask account)

N/A

$50,001 - $100,000

 

None (or less than $201)

2

“MiniCryptoWerewolf” (F-NFT representing 1% stake in 1 “CryptoWerewolf” NFT) (Coinbase account)

N/A

$1,001- $15,000

 

None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6
Reporting an NFT for a Virtual Item or Collectible

Report an NFT for a virtual item or collectible if

(1) the NFT is held for investment purposes and had a value that was more than $1,000 at the end of the reporting period

or

(2) the NFT was a source of more than $200 in income received during the reporting period.

Description: Provide the name of the NFT and indicate that the interest is an NFT. If held in a wallet hosted by an exchange or third-party platform, indicate the name of the exchange or platform on which it is held. If you do not maintain your NFTs in a wallet hosted by an exchange or third-party platform, it is helpful if you identify that your private keys are directly held (e.g., a noting “(held in hardware cryptocurrency wallet)” or “(held in cold wallet)”).

EIF: Select “N/A.”

Value: Report the value of the NFT by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Reporting an F-NFT for a Virtual Item or Collectible

Report an F-NFT for a virtual item or collectible if the F-NFT had a value that was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Note: For purposes of financial disclosure, F-NFTs are almost always deemed to be held for investment or the production of income. If you believe that, based on some unusual set of circumstances, your specific F-NFT is not property held for investment or production of income, consult with an agency ethics official.

Description: Provide the name of the F-NFT, indicate that interest is an F-NFT, and describe the underlying NFT. If held in a wallet hosted by an exchange or third-party platform, indicate the name of the exchange or platform on which it is held. If you do not maintain your F-NFTs in a wallet hosted by an exchange or third-party platform, it is helpful if you identify that your private keys are directly held (e.g., a noting “(held in hardware cryptocurrency wallet)” or “(held in cold wallet)”).

EIF: Select “N/A.”

Value: Report the value of the F-NFT by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Oil, Gas, or Other Mineral Rights Lease

Report leased oil, gas, or other mineral rights and income from the lease in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Oil lease, Fargo, ND –

Humble Oil and Refining Co.

N/A

$1,001 - $15,000

rent or royalties

$201 - $1,000

2

Natural gas lease, Dallas, TX –

El Paso Corporation

N/A

$50,001 - $100,000

signing bonus

$13,700

For You, Your Spouse, and Your Dependent Children

Part 6

Report a lease if the value of the lease was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Indicate that the asset is a lease and provide: (1) the location of the land (either city and state or county and state); (2) the resource being extracted under the terms of the lease; and (3) the name of the lessee (i.e., company extracting resources and paying royalties).

EIF: Select “N/A.”

Value: Report the value of the lease by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Leases normally produce “rent or royalties” income, but in some cases they may also produce dividends, interest, or capital gains. If the lease produces any other type of income, provide an appropriate description (e.g., “signing bonus” or “upfront payment”).

Income Amount:

(1) Income less than $201: Select the category for “None (or less than $201).”

(2) Dividends, capital gains, interest, rent, or royalties: Select the category that corresponds to the total amount of income received during the reporting period.

(3) Other income: Provide the exact amount of income received during the reporting period.

Click Here for Frequently Asked Questions

Option (put or call purchased)

Report a put or a call option that you purchased and income from the option in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Growlster, Inc. (GRWL), call option

N/A

$1,001 - $15,000

 

None (or less than $201)

2

Growlster, Inc. (GRWL), call option (value not readily ascertainable):

100 shares, strike $7, exp. 8/2022

N/A

 

None (or less than $201)

3

Widgets Unlimited (WIG), put option

N/A

None (or less than $1,001)

capital gains

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6
Reporting a Put or Call Option That You Have Not Exercised

Report a put or call option if its value was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the name of the option, which should include the name of the underlying security or index and the type of option (e.g., “Widgets Unlimited (WIG), put option”).

EIF: Select “N/A.”

Value: Report the value of the option by selecting the appropriate category. If the option is “underwater” or if the value of the option is otherwise difficult to determine, write “value not readily ascertainable” in the “Description” field and provide the following information: (1) the number of units of the security for which the option exists; (2) the strike price; and (3) the expiration date.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Options normally do not produce income until they have been exercised or sold.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period, which is usually “None (or less than $201).”

Reporting a Put Option on a Security That You Fully Exercised

If you fully exercised a put option, neither the option nor the underlying security will have any reportable value. Report the underlying security if more than $200 in income was received during the reporting period.

Description: Provide the name of the underlying security that you sold (e.g., “Widgets Unlimited (WIG)”).

EIF: Select “N/A.”

Value: Report the value of the underlying security by selecting the appropriate category, which should be “None (or less than $1,001).”

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. In some cases, the underlying security may have produced dividends or interest before you sold it. More often, you will have capital gains as a result of selling the underlying security.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Reporting a Call Option on a Security That You Fully Exercised

If you fully exercised a call option, the option will no longer have a value of its own, but the underlying security that you purchased may have reportable value or income. Report the underlying security if its value was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the name of the underlying security that you purchased (e.g., “Growlster, Inc. (GRWL)”).

EIF: Select “N/A.”

Value: Report the value of the underlying security by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. The exercise of the call option will not itself produce reportable capital gains; however, any subsequent sale of the purchased underlying security may produce capital gains. In addition, the purchased underlying security may have generated reportable dividend or interest income.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Reporting a Put or Call Option on an Index That You Fully Exercised

Report a put or call index option that you exercised if more than $200 in income was received during the reporting period.

Description: Provide the name of the option, which should include the name of the underlying index and the type of option (e.g., “S&P 500 Index (^SPX), put option”).

EIF: Select “N/A.”

Value: Report the value of the option by selecting the appropriate category, which should be “None (or less than $1,001).”

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. The exercise of index options ordinarily produce capital gains.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Reporting a Put or Call Option That You Resold

Report a put or call option that you resold if more than $200 in income was received during the reporting period.

Description: Provide the name of the option, which should include the name of the underlying security or index and the type of option (e.g., “Widgets Unlimited (WIG), put option”).

EIF: Select “N/A.”

Value: Report the value of the option by selecting the appropriate category, which should be “None (or less than $1,001).”

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Sales of options ordinarily produce capital gains.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

 

Option (put or call written)

Report a put or a call option that you wrote and income from the option in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Widgets Unlimited (WIG), open position for written put option:100 shares, strike $7, exp. 8/2022

N/A

   

None (or less than $201)

2

Xylophone Technologies Corporation (XYZ),closed position for written put option

N/A

None (or less than $1,001)

capital gains

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6
Open Position

Report a written put or call option in an open position if the value of the shares on which the option was written was more than $1,000 at the time the position was opened.

Description: Provide the name of the underlying security or index, the type of option, and an indication that the position is open. In addition, in lieu of selecting a category of value, provide the following information: (1) the number of units of the security or index for which the option exists; (2) the strike price; and (3) the expiration date.

EIF: Select “N/A.”

Value: Leave this field blank.

Income Type and Income Amount: You should not have any income to report, so select “None (or less than $201).”

Closed Position

Report a written put or call option in a closed position if more than $200 in income was received during the reporting period.

Description: Provide the name of the underlying security or index, the type of option, and an indication that the position is closed.

EIF: Select “N/A.”

Value: Report the value of the option by selecting the appropriate category, which should be “None (or less than $1,001).”

Income Type: Specify the type of income.

Income Amount: Select the category that corresponds to the total amount of income received during the reporting period.

Stock Acquired through an Exercised Option

Report the stock as you would any other stock.

Click Here for Frequently Asked Questions

Precious Metal

Report a precious metal and income from precious metal in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Gold coins

N/A

None (or less than $1,001)

capital gains

$2,501 - $5,000

2

Platinum bars

N/A

$250,001 - 500,000

None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6

Report precious metal if either of the following is true: (1) the metal is held for investment purposes and had a value that was more than $1,000 at the end of the reporting period or (2) the metal was a source of more than $200 in income received during the reporting period.

Description: Describe the type of metal owned (e.g., gold) and the form in which you hold the metal (e.g., ingots, jewelry, coins, or warehouse certificates).

EIF: Select “N/A.”

Value: Report the value of the precious metal by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

 

Prepaid Tuition Plan (529 plan)

Report a prepaid tuition plan and income from the plan in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Maryland Prepaid College Trust (MPCT), University Plan – 4 years

N/A

$15,001 - $50,000

 

None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6

Report a prepaid tuition plan if the value was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period. Income is ordinarily reported when payments are made.

Description: Provide the sponsoring state and the name of the plan.

EIF: Select “N/A.”

Value: Report the value of the plan by selecting the appropriate category. If you do not know the current value, you may use the cost of the plan at the time that you purchased it.

Income Type: If applicable, describe the type of income received as “cash payments” or “cash distributions.”

Income Amount: Provide the exact amount of income received during the reporting period. If you do not have such income to report, select the category for “None (or less than $201).”

Real Estate (general)

Report investment real estate and income from real estate in Part 6. Do not report your personal residence if it does not produce rental income.

Other requirements may apply (a) if the real estate is a farm, (b) if the real estate is held by a trust, (c) if the real estate is held by a limited liability company or other entity, or (d) if you have leased mineral rights associated with the property. These requirements are addressed below.

#

Description

EIF

Value

Income Type

Income Amount

1

Residential real estate, Des Moines, IA

N/A

$100,001 - $250,000

rent or royalties

$5,001 - $15,000

2

Commercial real estate, Charlotte, NC

N/A

None (or less than $1,001)

capital gains

$50,001 - $100,000

3

Undeveloped land, Rapid City, SD

N/A

$100,001 - $250,000

None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6

Report real estate if the value of the real estate was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

You do not need to report a personal residence if it is not rented out during any portion of the reporting period. A personal residence includes a vacation home that is not rented out.

Description: Describe the type of real estate (e.g., “residential,” “commercial,” “industrial,” or “undeveloped”) and provide the city and state in which it is located. Providing the county and state is also acceptable. Do not provide a street address.

EIF: Select “N/A.”

Value: Report the value of the real estate by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Usually the type of income will be “rent or royalties” or “capital gains.”

Income Amount:

(1) Income less than $201: Select the category for “None (or less than $201).”

(2) Dividends, capital gains, interest, rent, or royalties: Select the category that corresponds to the total amount of income received during the reporting period.

(3) Other income: Provide the exact amount of income received during the reporting period.

Mortgages

Report in Part 8 a mortgage that exceeded $10,000 at any point during the reporting period. An exception for mortgages on personal residences may apply. See Part 8 in this guide for details.

Other Requirements

Farm: If the real estate is a farm, consult the instructions in this guide for farms.

Holding Company: If the real estate is held through a limited liability company or other legal entity, consult the instructions in this guide for real estate holding companies.

Mineral Rights: If the real estate is associated with a mineral rights lease, consult the instructions in this guide for an oil, gas, or other mineral rights lease.

Trust: If the real estate is held in a revocable trust, consult the instructions in this guide for revocable trusts. If the real estate is held in an irrevocable trust, consult the instructions in this guide for irrevocable trusts.

Installment Sale: Report a note from an installment sale using the instructions in this guide for such notes.

Click Here for Frequently Asked Questions

Real Estate (installment sale)

Report in Part 6 an interest in an installment sale note and income related to the installment sale of an investment property.

#

Description

EIF

Value

Income Type

Income Amount

1

Note from Ms. Adebayo (due to installment sale of residential real estate, San Diego, CA)

N/A

$250,001 - $500,000

interest

capital gains

$15,001 - $50,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report an installment sale if the value of the note was more than $1,000 at the end of the reporting period or if you received more than $200 in income during the reporting period.

Description: Provide the name of the company or person who owes the note, indicate that the note is for an installment sale, describe the type of real estate (e.g., “residential,” “commercial,” “industrial,” or “undeveloped”), and provide the city and state in which the real estate is located. Providing the county and state is also acceptable. Do not provide a street address.

If the party who owes on the note is a family member, you may identify the party as a “family member”. If the party is a natural person (i.e., a human) who is not related to you, you may identify the party by last name only (e.g., “Ms. Adebayo”).

EIF: Select “N/A.”

Value: Report the value of the note by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount: Select the category that corresponds to the total amount of income received during the reporting period. Generally, with an installment sale, capital gains are apportioned over the life of the note for federal income tax purposes and that same method may be used for financial disclosure purposes. If you chose to recognize all income in the year of sale for federal income tax purposes, then that same method would be used for financial disclosure purposes.

 

Real Estate Holding Company (excluding REITs)

Report a real estate holding company and income from the company in Part 6.

Do not use this entry to report a mutual fund that holds REITs. See the entry for mutual funds instead. In addition, if you operate a trade or business involving real estate, see the entry for small businesses.

Real Estate Holding Company Qualifies as an EIF

#

Description

EIF

Value

Income Type

Income Amount

1

Baumvista Creek Holdings, LP

Yes

$100,001 - $250,000

 

$5,001 - $15,000

Real Estate Holding Company Does Not Qualify as an EIF – If you know the value of and income from the underlying assets

#

Description

EIF

Value

Income Type

Income Amount

1

Macon Real Estate V, LP

No

     

1.1

commercial real estate, Champaign, IL

N/A

$50,001 - $100,000

rent or royalties

$2,501 - $5,000

1.2

commercial real estate, Terre Haute, IN

N/A

$50,001 - $100,000

None (or less than $201)

1.3

commercial real estate, Louisville, KY

N/A

$15,001 - $50,000

capital gains

$5,001 - $15,000

Real Estate Holding Company Does Not Qualify as an EIF – If you know the value of the underlying assets but the income from those assets is not readily ascertainable

#

Description

EIF

Value

Income Type

Income Amount

1

Macon Real Estate V, LP

No

 

rent or royalties capital gains

$15,001 - $50,000

1.1

commercial real estate, Champaign, IL

N/A

$50,001 - $100,000

 

1.2

commercial real estate, Terre Haute, IN

N/A

$50,001 - $100,000

 

1.3

commercial real estate, Louisville, KY

N/A

$15,001 - $50,000

 

 

Real Estate Holding Company Does Not Qualify as an EIF – If the value of and income from the underlying assets are not readily ascertainable

#

Description

EIF

Value

Income Type

Income Amount

1

Macon Real Estate V, LP

No

$100,001 - $250,000

rent or royalties

capital gains

$15,001 - $50,000

1.1

commercial real estate, Champaign, IL

N/A

 

 

1.2

commercial real estate, Terre Haute, IN

N/A

 

 

1.3

commercial real estate, Louisville, KY

N/A

 

 

For You, Your Spouse, and Your Dependent Children

Part 6

Report an equity interest in a real estate holding company if the value of the interest was more than $1,000 at the end of the reporting period or if more than $200 in total income was received during the reporting period.

The reporting requirements will depend on whether the real estate holding company qualifies as an excepted investment fund. Real estate holding companies that may qualify include real estate investment trusts (REITs), as well as private equity and real estate hedge funds that are or were publicly available.

Real Estate Holding Company Qualifies as an EIF

Description: Provide the name of the real estate holding company and, unless it is clear from the name that you are reporting a real estate holding company, describe the type of asset.

EIF: Select “Yes.”

Value: Report the value of the real estate holding company by selecting the appropriate category.

Income Type: Leave this field blank.

Income Amount: Select the category that corresponds to the total amount of income received during the reporting period.

Real Estate Holding Company Does Not Qualify as an EIF

Description: Provide the name of the real estate holding company and, unless it is clear from the name that you are reporting a real estate holding company, describe the type of asset.

EIF: Select “No” for the real estate holding company.

Additional Disclosure of Underlying Assets: Because the real estate holding company does not qualify as an EIF, you need to report each underlying asset of the real estate holding company that was worth more than $1,000 at the end of the reporting period or from which more than $200 in income was received during the reporting period.

For purposes of valuing an underlying asset, you may use the value of the proportionate interest that you, your spouse, and your dependent children have in the underlying asset. For purposes of measuring income from an underlying asset, you may use the amount of income received from that underlying asset that is attributable to you, your spouse, and your dependent children.

In certain cases, real estate holding companies do not provide information regarding an investor’s interest in the value and/or income of the entity’s underlying assets. If you are unable to ascertain the value of the underlying assets, you may instead provide value information for the total interest that you, your spouse, and your dependent children have in the real estate holding company. Similarly, if you are unable to ascertain the income from the underlying assets, you may instead provide income information for the total interest that you, your spouse, and your dependent children have in the real estate holding company.

Click Here for Frequently Asked Questions

Real Estate Investment Trust (REIT)

Report a real estate investment trust (REIT) and income from a REIT in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Amalgamated Commercial Realty Trust (ACR)

N/A

$50,001 - $100,000

dividends

$2,501 - $5,000

2

BMSL Healthcare REIT (medical facilities)

N/A

None (or less than $1,001)

capital gains

$1,001 - $2,500

For You, Your Spouse, and Your Dependent Children

Part 6

Report a real estate investment trust if the value of the real estate investment trust was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the exact name of the real estate investment trust (e.g., “Amalgamated Commercial Realty Trust”). In addition, for a private real estate investment trust, identify any sector of concentration within the general area of real estate. For publicly traded real estate investment trusts, it is helpful to provide the ticker symbol in addition to the name of the real estate investment trust.

EIF: Select “N/A.”

Value: Report the value of the stock by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

 

Short Sale

Report short sales and income from short sales in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Widgets Unlimited (WIG), open short position: 1,000 shares at $25

N/A

   

None (or less than $201)

2

Xylophone Technologies Corporation (XYZ), closed short position

N/A

None (or less than $1,001)

capital gains

$5,001 - $15,000

For You, Your Spouse, and Your Dependent Children

Part 6
Open Position

Report a short sale in an open position if the value of the shorted security was more than $1,000 at the time the position was opened.

Description: Provide the name of the security you shorted (e.g., “Widgets Unlimited”) and indicate that the short position is open. In addition, in lieu of selecting a category of value, provide the following information: (1) the number of shares shorted and (2) the price at which you shorted the shares.

EIF: Select “N/A.”

Value: Leave this field blank.

Income Type and Income Amount: You should not have any income to report, so select “None (or less than $201).”

Closed Position

Report a short sale in a closed position if more than $200 in income was received during the reporting period.

Description: Provide the name of the security you shorted (e.g., “Xylophone Technologies Corporation”) and indicate that the short position is closed.

EIF: Select “N/A.”

Value: Select the category for “None (or less than $1,001).”

Income Type: Specify the type of income.

Income Amount: Select the category that corresponds to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

Solar Renewable Energy Credit Agreement

Report a solar renewable energy credit agreement and income in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Solar renewable energy credit agreement (value not readily ascertainable) – U.S. Photovoltaics

N/A

 

solar renewable energy credit

$1,310

For You, Your Spouse, and Your Dependent Children

Part 6

Report a solar renewable energy credit agreement if the value was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Indicate that the asset is a solar renewable energy credit agreement and provide the name of the entity paying income through the agreement.

EIF: Select “N/A.”

Value: Leave this field blank and write “value not readily ascertainable” in the Description field.

Income Type: Specify the type of income if the total amount of income received during the reporting period exceeded $200. Typically, a solar energy credit agreement would produce income that does not fall into one of the standard income types, so you would write “solar renewable energy credit.”

Income Amount:

(1) Income less than $201: Select the category for “None (or less than $201).”

 (2) Income more than $200: Provide the exact amount of income received during the reporting period.

 

Special Purpose Acquisition Company (SPAC)

Report a special purpose acquisition company (SPAC) and income from a SPAC in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Xylophone Technologies Corporation SPAC (pre-IPO, trust account with cash equivalents)

N/A

$15,001 - $50,000

 

None (or less than $200)

2

Rocket Research SPAC (RRS), units

N/A

$1,001 - $15,000

None (or less than $200)

3

Rocket Research SPAC (RRSS), shares

N/A

$1,001 - $15,000

None (or less than $200)

4

Rocket Research SPAC (RRSW), warrants

N/A

$1,001 - $15,000

None (or less than $200)

For You, Your Spouse, and Your Dependent Children

Part 6

Report a SPAC if the value of the SPAC was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the exact name of the SPAC (e.g., “Xylophone Technologies Corporation SPAC”). For a SPAC that has not yet been subject to an initial public offering (IPO), specify that the SPAC is in pre-IPO status and briefly describe the nature of the trust account holdings. For a SPAC that has been subject to an IPO, please note whether you are reporting the original SPAC units, SPAC shares, or SPAC warrants.

EIF: Select “N/A.”

Value: Report the value of the stock by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Stock

Report stock and income from stock in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Xylophone Technologies Corporation (XYZ)

N/A

$15,001 - $50,000

dividends

$201 - $1,000

2

BMSL Propulsion, Inc. (rocket fuel research)

N/A

None (or less than $1,001)

capital gains

$1,001 - $2,500

For You, Your Spouse, and Your Dependent Children

Part 6

Report a stock if the value of the stock was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the exact name of the stock (e.g., “Xylophone Technologies Corporation”). In addition, for stock of a privately held company, provide a description of the issuer’s trade or business (e.g., grain distributor, supermarket, financial advisory, etc.). For publicly traded stocks, it is helpful to provide the ticker symbol in addition to the name of the stock.

EIF: Select “N/A.”

Value: Report the value of the stock by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Stocks normally produce dividend income but may also produce capital gains if sold.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

 

Treasury Security

Report a Treasury security and income from the security in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

U.S. savings bonds

N/A

$15,001 - $50,000

interest

$201 - $1,000

2

U.S. Treasury bonds

N/A

None (or less than $1,001)

interest capital gains

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report a Treasury security if the value of the security was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the type of security held. You do not need to include the terms of the security.

EIF: Select “N/A.”

Value: Report the value of the security by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Treasury securities normally produce interest income but may also produce capital gains if sold.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

 

Trust (irrevocable)

Report an irrevocable trust in Part 6 if you, your spouse, or your dependent child has a reportable interest in the trust or received income from the trust. Report the underlying assets of an irrevocable trust if you, your spouse, or your dependent child has a reportable interest in the trust.

Reportable Current or Future Interest – Proportionate interest in the value and income of the underlying assets is readily ascertainable

#

Description

EIF

Value

Income Type

Income Amount

1

Family Trust #1:

No

     

1.1

QWERTY Growth Fund (QWTYX)

Yes

$50,001 - $100,000

 

$2,501 - $5,000

1.2

Philadelphia, PA, bonds

N/A

$1,001 - $15,000

interest

$201 - $1,000

1.3

Xylophone Technologies Corporation (XYZ)

N/A

None (or less than $1,001)

dividends capital gains

$201- $1,000

Reportable Current or Future Interest – Proportionate interest in the value of and income from the underlying assets is not readily ascertainable

#

Description

EIF

Value

Income Type

Income Amount

1

Family Trust #1:

No

$50,001 - $100,000

dividends interest

$5,001 - $15,000

1.1

QWERTY Growth Fund (QWTYX)

Yes

 

 

1.2

Philadelphia, PA, bonds

N/A

 

 

1.3

Xylophone Technologies Corporation (XYZ)

N/A

 

 

Reportable Current or Future Interest – Proportionate interest in the value of the underlying assets is not readily ascertainable; no income received

#

Description

EIF

Value

Income Type

Income Amount

1

Family Trust #1:See Endnote

No

$50,001 - $100,000

 

None (or less than $201)

1.1

QWERTY Growth Fund (QWTYX)

Yes

 

 

1.2

Philadelphia, PA, bonds

N/A

 

 

1.3

Xylophone Technologies Corporation (XYZ)

N/A

 

 

Endnote to #1: I have a 1/3 remainder interest in the trust. The current value of the trust is reported.

For You, Your Spouse, and Your Dependent Children

Part 6
Reporting a Trust

Report a trust if any of the following applies:

(1) Income Received: You, your spouse, and/or a dependent child received more than $200 in total income from the trust during the reporting period.

(2) Reportable Current Interest: You, your spouse, or a dependent child is currently entitled to receive income from the trust or to access the principal of the trust and the value of that interest was more than $1,000 at the end of the reporting period.

(3) Reportable Future Interest: You, your spouse, or a dependent child has a future interest in principal or income that is vested under controlling state law and the value of that interest was more than $1,000 at the end of the reporting period.

Description: Use initials (“J.S. 2003 Trust”) or a general description (“Family Trust #1”) in lieu of a full name.

EIF: Select “No.”

Value: Report the value of a reportable interest in the trust by selecting the appropriate category. Leave this field blank, however, if you are able to report the values of the underlying assets.

Income Type and Income Amount: Report the type(s) and amount of income received from the trust during the reporting period. Leave these fields blank, however, if you are able to report the income from the underlying assets.

Reporting the Underlying Assets of a Trust

Report an underlying asset of a trust if:

(1) you, your spouse, or a dependent child has a reportable current or future interest in the trust and

(2) the underlying asset was worth more than $1,000 at the end of the reporting period or you received more than $200 from the underlying asset during the reporting period.

Report each underlying asset using the guidance applicable to that type of asset.

For purposes of valuing an underlying asset, you may use the value of the proportionate interest that you, your spouse and your dependent children have in the underlying asset. Income from an underlying trust asset is treated as received if (1) it is clear it contributed more than $200 to a trust distribution or (2) the income is recognized for tax purposes by you, your spouse, or your dependent child.

In certain cases, beneficiaries cannot ascertain the proportionate interest that they have in the value and/or income of the trust’s underlying assets. If you are unable to ascertain the proportionate value of the underlying assets, you may instead provide a good faith estimate of the value of the total interest that you, your spouse, and your dependent children have in the trust. Similarly, if you are unable to ascertain the proportionate income from the underlying assets, you may instead report the total amount of income that you, your spouse, and your dependent children received from the trust.

Excepted Trusts: If you do not have a right to receive information regarding the underlying assets of a trust that someone else established for your benefit, you might be able to rely on a partial exception for “excepted trusts.”

Click here for more information on reporting an excepted trust.

Click Here for Frequently Asked Questions

Trust (revocable living)

Report assets and income from a revocable living trust in Part 6 if (1) you, your spouse, or your dependent child is the grantor or (2) you, your spouse, or your dependent child receives mandatory distributions.

See OGE DAEOgram DO-02-015 (June 11, 2002) for a detailed discussion of revocable living trusts.

#

Description

EIF

Value

Income Type

Income Amount

1

QWERTY Growth Fund (QWTYX)

Yes

$50,001 - $100,000

 

$1,001 - $2,500

2

Xylophone Technologies Corporation (XYZ)

N/A

None (or less than $1,001)

dividends capital gains

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6
Grantor Is You, Your Spouse, or a Dependent Child

Report each underlying asset of the trust that individually was worth more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period. Use the instructions specific to each type of asset (e.g., mutual funds, exchange-traded funds, stocks, corporate bonds, and cash accounts, such as certificates of deposit). You may identify that the assets are held in a revocable living trust, but this information is not required. If you choose to identify the trust, use initials (“J.S. 2003 Trust”) or a general description (“Family revocable trust”) in lieu of the full name.

Mandatory Distributions Received by You, Your Spouse, or a Dependent Child

Report the trust and each underlying asset of the trust that individually was worth more than $1,000 at the end of the reporting period or from which more than $200 in income was received during the reporting period. When reporting the trust itself, use initials (“J.S. 2003 Trust”) or a general description (“Family revocable trust”) in lieu of the full name.

Click Here for Frequently Asked Questions

UGMA or UTMA Account

Report the underlying assets of your dependent child’s Uniform Gifts to Minors Act (UGMA) account or Uniform Transfers to Minors Act (UTMA) account in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

ABC Diversified Bond Fund (ABCDX)

Yes

$50,001 - $100,000

 

$1,001 - $2,500

2

Xylophone Technologies Corporation (XYZ)

N/A

None (or less than $1,001)

dividends capital gains

$2,501 - $5,000

For Your Dependent Children

Part 6

Report each underlying asset of a Uniform Gifts to Minors Act (UGMA) account or Uniform Transfers to Minors Act (UTMA) account that individually was worth more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period. You may indicate that the assets are held within a UGMA or UTMA account, but this information is not required.

This guide contains specific instructions for common types of assets held within such an account (e.g., mutual funds, exchange-traded funds, stocks, and corporate bonds).

Click Here for Frequently Asked Questions

 

Unit Investment Trust

Report a unit investment trust (UIT) and income from the unit investment trust in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

First Trust International High Dividend Equity Portfolio (FGRWNX)

Yes

$15,001 - $50,000

 

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report a unit investment trust if the value of the unit investment trust was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the exact name of the unit investment trust (e.g., list “Invesco Van Kampen Intermediate Corporate Investment Grade Trust” rather than just “Invesco Van Kampen”). Providing the ticker symbol is also helpful.

EIF: Select “Yes.”

Value: Report the value of the unit investment trust by selecting the appropriate category.

Income Type: Do not complete this field for EIFs.

Income Amount: Select the category that corresponds to the total amount of income received during the reporting period.

Click Here for Frequently Asked Questions

Virtual Currency (cryptocurrency or stablecoin)

Report a holding of a virtual currency and income from the virtual currency in Part 6. This section applies both to cryptocurrency as well as stablecoins.

#

Description

EIF

Value

Income Type

Income Amount

1

Coinbase wallet

No

     

1.1

Bitcoin

N/A

$1,001 - $15,000

None (or less than $201)

1.2

Ether

N/A

None (or less than $1,001)

capital gains

$1,001 - $2,500

2

Litecoin (Poloniex wallet)

N/A

None (or less than $1,001)

capital gains

$1,001 - $2,500

3

Bitcoin (held in cold wallet)

N/A

$15,001 - $50,000

None (or less than $201)

4

Cardano, staked (Kraken delegated staking agreement)

N/A

$50,001 - $100,000

block rewards (Cardano)

$328

For You, Your Spouse, and Your Dependent Children

Part 6
Holding/Trading Virtual Currency without Mining or Staking

Report virtual currency if the value of the virtual currency was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the name of the virtual currency. If held in a wallet hosted by an exchange or third-party platform, indicate the name of the exchange or platform on which it is held. If you do not maintain your virtual currency keys through a wallet hosted by an exchange or third-party platform, it is helpful if you identify that your virtual currency keys are directly held (e.g., a noting “(held in hardware cryptocurrency wallet)” or “(held in cold wallet)”).

EIF: Select “N/A.”

Value: Report the value by selecting the appropriate category.

Income Type: Specify the type of income if the total amount of income received during the reporting period exceeded $200. OGE’s understanding at the present time is that income from trading virtual currency should be reported as a capital gain. If factual circumstances or tax requirements differ, please discuss the reporting requirements with your ethics official.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Passive Staking of Virtual Currency through Platform/Company

Report passively staked virtual currency if the value of the staked virtual currency was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the name of the virtual currency, indicate that the virtual currency is being staked through an agreement with a particular platform/company, and list the virtual currency in which block rewards would be given.

EIF: Select “N/A.”

Value: Report the value by selecting the appropriate category.

Income Type: Specify the type of income if the total amount of income received during the reporting period exceeded $200. At the present time, OGE requires block reward income to be described as “block reward” and for the type of virtual currency to be specified.

Income Amount: Provide the exact amount of block reward income received during the reporting period.

Click Here for Frequently Asked Questions

Warrant

Report a warrant acquired as a passive investor (i.e., not through business or employment activities) and income from the warrant in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Growlster, Inc. (GRWL), call warrant

N/A

$1,001 - $15,000

 

None (or less than $201)

2

BMSL Propulsion, Inc. (rocket fuel research), call warrant (value not readily ascertainable):

100 shares, strike $7, exp. 8/2028

N/A

 

None (or less than $201)

3

Widgets Unlimited (WIG), put warrant

N/A

None (or less than $1,001)

capital gains

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6
Reporting a Put or Call Warrant That You Have Not Exercised

Report a put or call warrant if its value was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description: Provide the exact name of the security for which the warrant was issued, write “warrant,” and indicate the type of warrant. In addition, for a privately held business, describe the line of business, unless you have already provided this information in another entry.

EIF: Select “N/A.”

Value: Report the value of the warrant by selecting the appropriate category. If the warrant is “underwater” or if the value of the warrant is otherwise difficult to determine, write “value not readily ascertainable” in the “Description” field and provide the following information: (1) the number of units of the security for which the warrant exists; (2) the strike price; and (3) the expiration date.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. Warrants normally do not produce income until they have been exercised or sold.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period, which is usually “None (or less than $201).”

Reporting a Put Warrant on a Security That You Fully Exercised

If you fully exercised a put warrant, neither the warrant nor the underlying security will have any reportable value. Report the underlying security if more than $200 in income was received during the reporting period. In addition, for a privately held business, describe the line of business, unless you have already provided this information in another entry.

Description: Provide the name of the underlying security that you sold (e.g., “Widgets Unlimited (WIG)”).

EIF: Select “N/A.”

Value: Report the value of the underlying security by selecting the appropriate category, which should be “None (or less than $1,001).”

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. In some cases, the underlying security may have produced dividends or interest before you sold it. More often, you will have capital gains as a result of selling the underlying security.

Income Amount: Select the category corresponding to the total amount of income received during the reporting period.

Reporting a Call Warrant on a Security That You Fully Exercised

If you fully exercised a call warrant, the warrant will no longer have a value of its own, but the underlying security that you purchased may have reportable value or income. Report the underlying security if its value was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period. In addition, for a privately held business, describe the line of business, unless you have already provided this information in another entry.

Description: Provide the name of the underlying security that you purchased (e.g., “Growlster, Inc. (GRWL)”).

EIF: Select “N/A.”

Value: Report the value of the underlying security by selecting the appropriate category.

Income Type: Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200. The exercise of the call warrant will not itself produce reportable capital gains; however, any subsequent sale of the purchased underlying security may produce capital gains. In addition, the purchased underlying security may have generated reportable dividend or interest income.

Income Amount: Select the category that corresponds to the total amount of income received during the reporting period.

Will or Estate

Generally, report the following interests in Part 6: (1) assets distributed from an estate and (2) a beneficial interest in an estate that has not yet been distributed. In addition, report any fees you received as an executor or administrator in Part 2 and any fees your spouse received in Part 5. Do not report an interest in the will of a living person.

Assets Distributed from an Estate

#

Description

EIF

Value

Income Type

Income Amount

1

Xylophone Technologies Corporation (XYZ)

N/A

$1,001 - $15,000

dividends

$201 - $1,000

2

QWERTY Growth Fund (QWTYX)

Yes

$50,001 - $100,000

$1,001 - $2,500

Beneficial Interest in an Estate (assets not yet distributed)

#

Description

EIF

Value

Income Type

Income Amount

1

Estate of a family member (value not readily ascertainable)

N/A

   

None (or less than $201)

There are many types of wills, and wills are established and interpreted under state law. The guidance provided here and in other sections of this guide addresses the most common situations. It is recommended that you work with an ethics official at your agency to determine whether and how to disclose information about a will or an estate.

Note that the wills and estates discussed in this section do not involve trusts. Consult an ethics official at your agency if the will or estate involves a trust.

For You, Your Spouse, and Your Dependent Children

Part 6
Reporting Assets Distributed from an Estate

Report each distributed asset that individually was worth more than $1,000 at the end of the reporting period or from which more than $200 in income was received during the reporting period. Count income produced by the asset only after it was distributed to you, your spouse, or your dependent children.

This guide contains specific instructions for common types of assets that you may hold (e.g., mutual funds, exchange-traded funds, stocks, and corporate bonds).

 

Reporting a Beneficial Interest in an Estate That Has Not Been Distributed

Report a beneficial interest if the interest was worth more than $1,000 at the end of the reporting period or if more than $200 in income (excluding inheritance) was received during the reporting period.

Description: Identify the estate. If the estate is that of a family member, you may write “estate of a family member.” In other cases, identify the estate by the last name of the party (e.g., “Estate of Ms. Nagata”).

EIF: Select “N/A.”

Value: Report the value of the estate interest. If you cannot ascertain the value of this interest, leave the “Value” field blank and write “value not readily ascertainable” in the “Description” field.

Income Type and Income Amount: If income (excluding inheritance) in excess of $200 was received during the reporting period, report the type and amount. If such income did not exceed $200, select the category for “None (or less than $201).”

Wills of Living Persons

You do not need to report any interest in the will of a living person. Note, however, that other reporting requirements may apply if the person has established a trust.

Click Here for Frequently Asked Questions