Andy Oldham From: Andy Oldham Sent: Monday, May 22, 2017 7:48 PM To: Kingo, Lola A. {OLP) Ce: (ll)(G) - Andrew Oldham Email Address ; Talley, Brett (OLP}; Shannon, Gail Subject: Re; Background Investigation Attachments: SCAN_20170522184215.pdf Dear Lola -- thank you very much. I am looking forward to working with you, too. Attached are the SF86 Supplement, the Credit Check Waiver, and the Tax Waiver. The Immigration Addendum does not apply to me. I will get started on the SF86 ASAP. And I already have two fingerprint cards, which I will take to the police station first thing in the morning. Thank you again. Andy On Mon, May 22, 2017 at 6:15 PM, Kingo, Lola A. (OLP} <[email protected]> wrote: Dear Andrew, I work with Deputy Assistant Attorney General Brett Talley (copied) in the U.S. Justice Department's Office of legal Policy, which vets candidates for federal judgeships. The White House has asked us to work with you on a series of forms that will be used in connection with your FBI background investigation. Our goal is to initiate your background investigation no later than Friday, May 26. Before we can initiate your background investigation, there-are a number of documents for you to review and complete, mainly the: • SF86 (completed via e-QIP) - We have generated an SF86 for you to complete in e--QIP in connection with the FBl's background investigation. You should receive an email inviting you to get started on your SF86 from the Offic.e of Personnel Management. To get started, please follow the attached e-QIP applicant instructions. If you have any trouble acce-ssing e-QIP, please contact Gail Shannon (copied), who can be reached via email or during business hours at {724} 794-5612 x7764 (office) and after business hours at {724) 612-8679 (mobile). • SF86 Supplement (attached Word DOC) - In addition to the Sf86 that you complete via e­ QIP, please complete the attached SF86 Supplement. Oldham; 0001 • Additional Instructions (attached Word DOC) - The attache-d instructions are especially important because they contain instructions that supersede some of the instructions on the forms themselves {for example, we ask you to list your Residence and Employment Histories back to age 18, ratherthan just going back 7 years as the SF86 specifies). Please remember to sign the Additional Instructions. • Credit Check Waiver (attac-hed PDF) and Tax Chec-k Waiver (attached PDF) - These are additional waivers needed for aspects of your background investigation. Please do not date or sign the tax check waiver electronically as it will delay processing, rather please handwrite the date and sign the hard copy. • Immigration Addendum (attached PDF) - Only complete- the Immigration Addendum if applicable to you. • Fingerprint Cards (sent via FedEx) - We have mailed you two sets of fingerprint cards, which you should promptly take to your local police station, FBI office, or a private company, to get your fingerprints taken. Once you have completed the SF86 via e-QIP, please re-lease it back to OLP for review. Also, once you complete the SF86 Supplement, Additional Instructions, Waivers, and Immigration Addendum (if applicable), please email them to me. Finally, once your fingerprints are taken, please return the cards via overnight mail to the address in my signature block. We look forward to·working with you. If you have any questions about the fo rms, please let me know. I can be reached at 202-514-1818 (office} an {mobile}. Thank you. Lola A. Kingo Senior Nominations Counsel Office of legal Policy {OLP} U.S. Department of Justice 950 Pennsylvania Avenue, NW Oldham; 0002 Room 4239 Washington, O.C. 20530 /202) 514-1818 Lola.A.Kingo@usdo j.gov Oldham; 0003 SF-86 Supplement Note: For all ofthe following questions, please provide as much detail as possible. 1. Have you or your spouse ever registered as an agent for, perfonned work for, received any payments from and/or made any payments to, any foreign government, foreign business, or non­ profit organization with any foreign government ownership? If yes, please provide: a. Name of foreign government/business/non-profit with which you dealt; b. Address/telephone ofthe organization(s); c. Date ofpayment; d. Amount ofpayment; e. Circumstances. (b) (6) I 2. Has a tax lien or other collection procedure ever been instituted against you or your spouse by federal, state, or local authorities? Ifyes, please provide: a. Date of tax lien/collection procedure; b. Recipient of action (you and/or your spouse); c. Source ofaction (specific local/state/federal authority); d. Circumstances; e. Resolution of the action. (b) (6) 3. Have any claims of sexual harassment, racial discrimination, or any other workplace misconduct, ever been made against you or any employee directly supervised by you? Ifyes, please provide: a. Type ofclaim; b. Organization/business/entity where it took place; c. Date of claim; d. Your involvement in the claim; ll Page Oldham; 0004 e. Nature of allegations/circumstances; f. Resolution ofthe claim. (b) (6) 4. To your knowledge, have you or your spouse, or has either of your conduct been the subject of any civil or criminal case, administrative proceeding, or government investigation, other than a minor traffic infraction? Ifyes, please provide: a. Type of proceeding (e.g., civil case); b. Date(s) ofproceeding; c. Nature of your involvement, issue(s) and disposition; d. Location ofRecords (e.g., court); e. issues(s) and disposition; f. Location ofrecords (e.g. court). g. Name/address/telephone ofGeneral counsel/other official (b) (6) 5. Have you ever paid late or had lapses in payment of child support and/or alimony owed by you? If yes, please provide: a. Date of late payment(s)/lapse(s); b. State/local authority handling the matter; c. Circumstances; d. Resolution ofthe matter. (b) (6) 6. Do you have any current or former professional licenses/membership such as bar associations, medical licenses, real estate licenses, etc.? Ifyes, please provide: a. Type of license/membership; b. Location; 21P ag c Oldham; 0005 c. License number; d. Date issued/expiration; e. Details of any complaints, citations, disciplinary actions, etc. against you. I have three bar licenses. Virginia State Bar, License Number 71330, Issued October 2005 District of Columbia Bar, License Number 999098, Issued February 7, 2011 Texas State Bar, License Number 24081616, Issued June 21, 2012 (b)(6) 7. With as much detail as possible, please provide any other information, including information about other members ofyour family, which could suggest a conflict of interest, be a possible source ofembarrassment, or be used to coerce or blackmail you. (b) (6) 3IPag e Oldham; 0006 (1/9/10) THE WHITE HOUSE WASHINGTON PRIVACY ACT PROTECTED INFORMATION (When Completed) Disclosure and Authorization Pertaining to Consumer Reports Pursuant to the Fair Credit Reporting Act This is a release for the Federal Bureau of Investigation and/or the Office of Counsel to the President, acting on the President's behalf, to obtain one or more consumer/credit reports about you in connection with consideration ofyour appointment to a position within the Executive Branch or the Federal Judiciary, or in the course ofyour employment with the Federal Government. One or more reports about you may be obtained for employment purposes, including evaluating your fitness for employment, promotion, reassignment, retention, or access to classified infonnation. 1, A- N\)it tl,J S,Er H £,J OLDHAM , hereby authorize the Federal Bureau of Investigation and/or the Office of Counsel to the President, acting on the President's behalf, to obtain such reports from any consumer/credit reporting agency for employment purposes. Social Security Number Oldham; 0007 U.S. Department of Justice Tax Check Waiver I am signing this waiver to permit the Internal Revenue Service to release information about me which would otherwise be confidential. This information will be used in connection with my appointment or employment by the United States Government. This waiver is made pursuant to 26 U.S.C. §6103(c). I request that the Internal Revenue Service release the following information to Lola Kingo (Senior Nominations Counsel), Bridget C. Coehins, or designee of U.S. Department of Justice: I. Have I failed to file any Federal income tax return for any ofthe last three years for which filing of a return might have been required? (Ifthe filing date without regard to extensions and nonnal processing period for most recent year's return has not yet elapsed on the date IRS receives this waiver, and the IRS records do not indicate a return for the most recent year, the "last three years" will mean the three years preceding the year for which returns are currently being filed and processed.) 2. Were any of the returns in #1 filed more than 45 days after the due date for filing (determined with regard to any extension(s) of time for filing)? 3. Have I failed to pay any tax, penalty or interest during the current or last three calendar years within 45 days of the date on which the IRS gave notice ofthe amount due and requested payment? 4. Am I now or have I ever been under investigation by the IRS for possible criminal offenses? 5. Has any civil penalty for fraud been assessed against me during the current or last three calendar years? I authorize the IRS to release any additional relevant information necessary to respond to the questions above. To help the IRS find my tax records and the Department ofJustice to evaluate my tax history, I am voluntarily giving the following information: MYNAME: ANt>tew ~t£fH-EN 01-e>HAM MYssN: (Please print or t e) CURRENT ADDRESS: TELEPHONE NUMBERS: (HOME) (Please I F MARRIED AND .