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REVIEW/APPROVAL FORM FOR WIDELY ATTENDED GATHERINGS (WAG) Name of Employee James Zwiebel, M.D. Signature of Employee Telephone Number 301.496.1196 IC (for blanket determination) Name of Supervisor Jeffrey Abrams, MD Name of Conference or event (WAG) Molecular Targets conference Reception and Dinner Date of Request Tuesday, November 17, 2009 Date of WAG Location of WAG Top of the Hub Restaurant and Skywalk in the Prudential Tower at 800 Boylston Street in Boston, Massachusetts Time of WAG reception from 7:45 p.m. to 8:30 p.m., followed by dinner from 8:30 p.m. to 10:30 p.m. 7.30 – 9.00 pm Provided below are the elements that need to be assessed to determine if acceptance of an offer of free attendance is appropriate under the exception to the gift rule found in the Standards of Ethical Conduct for Employees of the Executive Branch (5 CFR Part 2635.204(g)). The employee initiating the request completes Questions 1-9. The employee should consult with the Ethics Coordinator (EC) to determine if Question 10 and all its elements must be addressed. The employee forwards the completed checklist to the EC for review and recommendation. 1. Is the employee assigned on official duty to participate as a speaker, panel member or otherwise to present information on behalf of NIH at a conference or similar engagement? Yes x No γ If yes, attendance on the day(s) of the employee's actual presentation is a customary and necessary part of his performance of the assignment and does not involve a gift to the individual or the NIH. No further action is necessary. γ If No, or the invitation includes attendance for days when the employee will not be making a presentation, proceed to Question 2. 2. Has someone other than the sponsor of the event designated the employee to be invited and will someone other than the sponsor bear the cost of the employee's attendance? NO γ If the answer to either is No, proceed to Question 3. γ
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