Form-Specific Questions
For additional assistance, please review the form completion guidance from the Illinois Secretary of State
The numbers listed below correspond directly to the numbers listed on the form. If you have additional questions, please contact the University Ethics and Compliance Office on the Ethics Line at: 866-758-2146 or via e-mail at: ethicsofficer@uillinois.edu
GENERAL NOTE: Attachments are often unecessary for these filings unless you have additional information that cannot be included in the space provided for that question. Please DO NOT include attachments with personally identifying information, such as tax forms (1099, tax returns, etc.). Also - NOTHING related to your university position needs to be listed. Please only include information that is outside of and unrelated to your work with the University of Illinois.
Question #1
If you have any single asset that was worth more than $10,000 as of the end of the preceding calendar year and is held in, or payable to, your name, held jointly by, or payable to, you with your spouse, or held jointly by, or payable to, you with your minor child, list such assets below. In the case of investment real estate, list the city and state where the investment real estate is located. If you do not have any such assets, list "none" below.
Just list the Asset, NOT the amount or account information. For example:
- Apple Stock
- Rental Property in Naperville, IL
Assets that Need to be Reported (Items typically listed under assets) Include:
- any single block of stock, public bonds, or commodity futures worth $10,000 or more in one company (name only - NOT THE AMOUNT)
- investment real estate, farmland, and rental property (other than your personal residence - list the city and state only)
- sector mutual and sector exchange traded fund –funds of more than $10,000 invested in a particular industry - or business beneficial interests in trusts
- business interests
- partnership interests
Assets that DO NOT Need to be Reported Include:
- personal residences and vehicles
- retirement accounts (Roth IRA, TIAA, Fideltiy, etc.)
- tangible personal property
- savings/checking accounts, CD's, notes/bonds/securities issued by a government entity
- college savings plans that qualify as tuition plans
- Medicare benefits
- inheritances and bequests (other than beneficial interests in trusts)
- diversified investment funds (e.g. mutual or exchange-traded funds invested in a wide variety of securities across multiple sectors or asset classes)
*Spouse includes a party to a marriage, civil union, or a registered domestic partner.
Question #2
Excluding the position for which you are required to file this form, list the source of any income in excess of $7,500 required to be reported during the preceding calendar year. If you sold an asset that produced more than $7,500 in capital gains in the preceding calendar year, list the name of the asset and the transaction date on which the sale or transfer took place. If you had no such sources of income or assets, list "none" below.
Just list the source, NOT the amount of income. For example:
- spouse works for Microsoft, just list Microsoft
- For pension income or other income from whatever source derived, (for private practices or consulting work) just list the NAME of the practice or company.
Please list the source of income/name of asset for any income or capital gains and date sold, if applicable, reported on your federal tax return more than $7,500.
- Revenue from leases, rentals, royalties, prizes, awards
- forgiveness of debt
- any annuities earned from trusts in excess of $7,500 should also be reported for this question.
*This includes income reported on but not limited to form 1099, W-2, and K-1.
Question #3
Excluding debts incurred on terms available to the general public, such as mortgages, student loans, and credit card debts, if you owed any single debt in the preceding calendar year exceeding $10,000, list the creditor of the debt below. If you had no such debts, list "none" below.
General Definitions:
- Creditor means an individual, organization, or other business entity to whom money or its equivalent is owed, no matter whether that obligation is secured or unsecured, except that if a filer makes a loan to members of his or her family, then that filer does not, by making such a loan, become a creditor.
- Debt means any money or monetary obligation owed at any time during the preceding calendar year to an individual, company, or other organization, other than a loan that is from a financial institution, government agency, or business entity and that is granted on terms made available to the general public. "Debt" includes but is not limited to: personal loans from friends or business associates, business loans made outside the lender's regular course of business, and loans made at below market rates
- Family includes a filer's spouse, children, step-children, parents, step-parents, siblings, step-siblings, half-siblings, sons-in-law, daughters-in-law, grandparents, and grandchildren, as well as the parents and grandparents of the filer's spouse, and any person living with the filer.
List creditor name only, NOT AMOUNT, IF debt incurred in the previous calendar year by you, you and your spouse, and you and your minor child exceeds $10,000. For example:
- Loan Company name
- Friend/Business Associate name
Debt that Needs to be Reported:
- personal loans from friends/business associates
- loans made at below-market rates
- business loans made outside the lender's regular/normal course of business
Debt that DOES NOT Need to be Reported (because generally available to the public):
- mortgage
- student loans
- credit card debt
- auto loans
Question #4
List the name of each unit of government of which you or your spouse were an employee, contractor, or office holder during the preceding calendar year other than the unit or units of government in relation to which the person is required to file and the title of the position or nature of the contractual services.
Here, you need to list the name of any unit of government and position title or nature of services for which you or your spouse were an employee, contractor, or office holder during the preceding calendar year, except for your university position (the position requiring you to file). All positions must be listed, regardless of compensation. Examples include:
- School Board
- Zoning Board
- County Board
- Park Board
- Army Guard
- Air Guard
- employment by other state agency or state university
- previously held positions with other state agencies
Do not list your University of Illinois position.
*Spouse includes a party to a marriage, civil union, or a registered domestic partner.
Question #5
If you maintain an economic relationship with a lobbyist or if a member of your family is known to you to be a lobbyist registered with any unit of government in the State of Illinois, list the name of the lobbyist below and identify the nature of your relationship with the lobbyist. If you do not have an economic relationship with a lobbyist or a family member known to you to be a lobbyist registered with any unit of government in the State of Illinois, list "none" below.
General Definitions:
- Family includes a filer's spouse, children, step-children, parents, step-parents, siblings, step-siblings, half-siblings, sons-in-law, daughters-in-law, grandparents, and grandchildren, as well as the parents and grandparents of the filer's spouse, and any person living with the filer.
- Lobbyist is an individual or entity required ot register to engage in lobbying activities under the Lobbyist Registration Act (25 ILCS 10/1, et seq).
For this question, list any lobbyists in which you maintain an economic relationship with. Also, list any family members who are lobbyist registered within the State of Illinois. For example, if your spouse or business partner is a lobbyist, this must be listed. You must list their name and the relationship to you: e.g., family member name, economic.
This is often N/A for filers since most do not have a family member who is a lobbyist or an economic relationship with a lobbyist.
Question #6
List the name of each person, organization, or entity that was the source of a gift or gifts, or honorarium or honoraria, valued singly or in the aggregate in excess of $500 received during the preceding calendar year and the type of gift or gifts, or honorarium or honoraria, excluding any gift or gifts from a member of your family that was not known to be a lobbyist registered with any unit of government in the State of Illinois. If you had no such gifts, list "none" below.
Just list the Name of the giver, not the amount. For example:
For this question, you must list any gift received where the value, singly or in aggregate, was greater than $500. Honorarium or honoraria are considered gifts for the purpose of this question.
You do not need to list gifts from family members unless they are registered lobbyists in Illinois.
Question #7
List the name of any spouse or immediate family member living with the person making this statement employed by a public utility in this State and the name of the public utility that employs the relative.
General Definitions:
- Family includes a filer's spouse, children, step-children, parents, step-parents, siblings, step-siblings, half-siblings, sons-in-law, daughters-in-law, grandparents, and grandchildren, as well as the parents and grandparents of the filer's spouse, and any person living with the filer.
- Spouse includes a party to a marriage, civil union, or a registered domestic partner.
- Utilities include electric, natural gas, telecommunications, water, and sewer.
For this question, just list the family member Name and Utility of employment. For example:
- John Smith, Rural Electric
This is often N/A for filers since most do not have a spouse or family member living in their household who is employed by a public utility in Illinois.
For information specific to the Supplemental Statement of Economic Interests form, please visit the Supplemental Statement of Economic Interest Form of our website.