University of Illinois

University Ethics Office

Blank Statement of Economic Interests Form

A blank form can be printed from the following site:

http://www.cyberdriveillinois.com/departments/index/ixeei.pdf

 

If you print a form from the above site, please be sure to document the following information in the blank space at the top of the page:

Name: First and Last

Home Mailing Address: This information will be used by the Office of the Secretary of State to mail you a confirmation of receipt.

University of Illinois: You must document that you are from the University of Illinois to ensure the Office of the Secretary of State can identify you as a filer.

Don't forget to sign and date your form and keep a photocopy for yourself!

 

All forms submitted before April 22, 2009 should be returned via US Mail to the University Ethics Office:

University Ethics Office
Human Resources Building, Room 20
One University Plaza, HRB 20
Springfield, IL 62703-5407

**For UIC and UIUC employees, there is no campus mail to the Ethics Office, so you MUST place your form in US Mail.

All forms submitted after April 22, 2009 should be mailed directly to the Office of the Secretary of State at:

Office of the Secretary of State
Ethics Section, Index Department
111 East Monroe
Springfield, IL 62756

 

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