GameStop 2010 Annual Report Download - page 134

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Appendix B
GIFT RECEIPT APPROVAL FORM
Name:
Office/Department:
Date:
1. Instructions
Associates are required to file a Gift Receipt Approval Form when situations arise that create an actual, potential, or apparent conflict of interest. Officers of
GameStop and any Associates who purchase goods or services for GameStop or who enter into and administer contracts on behalf of GameStop or who are
responsible for sensitive or confidential information are also required to complete this form when they receive a gift valued at greater than $1000 for their
personal use or enjoyment.
2. Gift Declaration
Recipient Name
Gift Dollar Value (You, Family or Donor Organization
Received of Gift Household Member) and Type of Business
3. Associate's Certification
The above is an accurate and current statement of all gifts I have received for my personal use and enjoyment.
Associate Signature:
Date:
4. Department Head's Certification
I certify, to the best of my knowledge, that the person named above has not received any gifts valued at over $1000 for personal use and enjoyment other
those submitted.
Department Head's Signature:
Date:
When a gift valued at over $1000 is received, please forward a copy of the signed Appendix B to Shirley Granado in the Finance Department.
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