FMCSA Ethics Vetting request

Name of the Event

Location of the Event

Event Start Date

Event Time

Event End Date

Event Sponsor(s)

Event Sponsor POC

Submitted by

Submitted By Email (DOT Email)

For whom is this vetting request being submitted?

Name(s) of FMCSA Attendees

Type(s) of Attendees (check all that apply)

Other Type of Attendees

Event Type

Specify Other Event Type

Do you have URL or Attachment for Event Invitation?

URL for Event Invitation

Speaking Event

Purpose of the event; Relation of the event to current FMCSA programs/initiatives

Is this event or the topics that will be discussed connected to ongoing, sensitive matters in your office (e.g., rulemakings, contracts, grants, litigation, etc.)?

Sensitive Matters - Please Explain

Is event sponsor a DOT or FMCSA contractor, grantee, or regulated entity?

Select type of DOT or FMCSA

Is the event sponsor or any of the attendees a registered lobbyist?

Name(s) of lobbyist

Do you intend to attend any other part of the event?

Is the other event(s) taking place on the same day that you will be speaking?

In addition to the session at which you are speaking, do you plan to attend any other sessions or days of the event?

Is the event local (within 50 miles of duty station)?

Will you be on official travel during this event?

Are you participating in this event in your official or personal capacity?

Event Attendance

Purpose of the event

Relation of the event to current FMCSA programs

Is this event or the topics that will be discussed connected to ongoing, sensitive matters in your office (e.g., rulemakings, contracts, grants, litigation, etc.)?

Please Explain with sufficient length, preferably paragraph

Is event sponsor a DOT or FMCSA contractor, grantee, or regulated entity?

Select type of DOT or FMCSA Sponsor

Is the event local (within 50 miles of duty station)?

Will you be on official travel during this event?

Are you being offered any free attendance, meals, or travel expenses?

Award Acceptance

Name of the award and organization

Is the award being offered by a private foundation

Please provide your grade level

Please check the following type of gifts, benefits, and other items being offered to applicant and/or member of the applicant's family to be received at or in conjunction with award/event

Provide market value for cash, stipends, cash equivalents

Please describe and specify the market value for Entertainment

Please describe and specify the market value for Lodging

Please describe and specify the market value for Meals

Please describe and specify the market value for Free Attendance

Please describe and specify the market value for Reimbursements

Please describe and specify the market value for Transportation

Please describe and specify the market value for tangible item

Please describe all other benefits and specify the market value for them

Is the award a cash award or have a market value greater than $200?

Is the award being offered by an entity that has interests, or an association or organization the majority of whose members have interests, that may be substantially affected by the performance of your official duties?

Please explain

Is the award an honorary degree from an institution of higher education?

From what institution is the honorary degree being awarded?

Did you solicit the award?

What is the basis for the award (e.g., meritorious public service or achievement, etc.)?

Is the award being given pursuant to an established program of recognition (e.g., award given on a regular basis or will be given on a regular basis)?

Is there a standard for selection of the award?

Have you accepted other gifts or awards from the same entity/organization?

Please Explain

Ride-Along

What is the purpose of the ride-along?

Was this ride-along arranged through a trucking association?

Which trucking association?

How was this ride-along arranged?

Name of motor carrier and its DOT Number

How was this motor carrier selected?

Name of driver

How was the driver selected?

Is this ride-along part of a greater event?

Please Explain

Other Type of Invitation

Please describe the nature of the invitation.

Attachment for EventYou can upload a maximum of 1 file, up to 90MB.

FMCSA Ethics Vetting request

Speaking Event

Event Attendance

Award Acceptance

Ride-Along

Other Type of Invitation

Speaking Event Details

Event Attendance Details

Award Acceptance Details

Ride-Along Details

Other Type of Invitation

Speaking Event

Event Attendance

Award Acceptance

Ride-Along

Other Type of Invitation

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Speaking Event Details

Event Attendance Details

Award Acceptance Details

Ride-Along Details

Other Type of Invitation

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File upload limit reached

Unsupported file formats