Blank Form

Click here to print and complete a blank form.


If you print a form from the above link, 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.


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


For more information on deadlines, mailing requirements and penalties, please visit the Deadlines, Mailing Details and Penalties section of our website.

For information specific to the Supplemental Statement form, please visit the Supplemental Statement of Economic Interest Form page of our website.