Employee Disclosure Forms

This page references a multitude of disclosure forms, some of which are managed internally, and others that are filed with external agencies.  Each form contains a brief description to assist employees in locating and completing their forms, as well as contact information for the unit or agency responsible for assisting employees with questions regarding respective disclosures.

External Disclosure Forms

Statement of Economic Interests Form

This form must be completed by individuals meeting criteria defined within the Illinois Governmental Ethics Act - it is not a requirement of all University employees. The disclosure concerns ownership and interests external to an employee's work at the University.  Though this form is reviewed internally by the University Ethics and Compliance Office prior to filing, it is ultimately filed with the Office of the Secretary of State. Form-specific instructions and further information regarding this external requirement can be found in the Statement of Economic Interests section of our website

Supplemental Statement of Economic Interest (Yellow or Electronic) Form

New in 2015, this form resulted from Illinois Executive Order 15-09 and is filed with the Illinois Executive Ethics Commission (EEC). The form further identifies potential conflicts with the State of Illinois. Unlike the Statement of Economic Interests, however, this form does not require review by the University Ethics and Compliance Office.  Additionally, employees can file this form electronically with the EEC.  For additional information related to this form, please visit the Supplemental Statement of Economic Interests section of our website.

Revolving Door Determination Forms (RD-101, RD-102, RD-103)

There are a series of forms required for university (state agency) employees seeking a revolving door determination to submit to the Office of Executive Inspector General for the Agencies of the Illinois Governor (OEIG) prior to accepting employment with a non-state employer for whom, the employee was involved in regulatory or licensing decisions, or was involved in the award of a contract to the non-state employer in the year prior to their departure from university employment.  Further information regarding this requirement can be found in the Revolving Door Employment section of our website as well as on the OEIG's website.

  • RD-101 - this form must be completed by the former university employee (remember, the prohibition does not come into play until employment is terminated with the university and lasts for one full year following termination of employment), regarding their involvement with the prospective employer.
  • RD-102 - this form must be completed by the University Ethics Officer, regarding the former employee's involvement with the prospective employer from a University perspective.
  • RD-103 - this form must be completed by the perspective employer.

Former employees should complete the RD-101 and submit it to the University Ethics and Compliance Office with their request for the University Ethics Officer to complete the RD-102 form.  The University Ethics Officer will then submit both forms to the OEIG for review and response.

 

Internal Disclosure Forms

Report for Non-University Activities

This form is required of all academic staff and must be completed annually.  Outside activities disclosed on the form are approved through an employee's reporting line and filed within their unit.  The form is distributed each fall by the Office of the Vice President for Research, but employees should update their "RNUA" form prior to accepting any additional employment or opportunities outside of their university position.  This form must be completed once annually even if there is no conflict of commitment and/or interests.  For more information on this form or to learn more about the University Policy on Conflicts of Commitment and Interests, please see the Executive Vice President/Vice President for Academic Affairs website.  Questions regarding this process or conflicts of interest should be directed to an employee's respective Office of the Vice Chancellor for Research.

Civil Service Disclosure Form

Employees with a Civil Service employment classification are also required to disclose any potential conflicts of commitment or interest to their supervisor in writing and obtain approval prior to accepting any type of outside income-producing employment.  Though the process is not as formal as the RNUA process for academic staff, disclosure is required nonetheless.  A disclosure form has been developed to assist Civil Service employees with disclosing outside income-producing activities and can be located on the Vice President for Research website.  For additional information regarding this process, employees should reference the Guidelines for Civil Service Employees on the Vice President for Research website.

 

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