Forms

Some of the forms below are available in fillable formats. Completion and submission of those forms requires the use of Adobe Acrobat reader software. The downloadable Acrobat Reader software is available at NO CHARGE from Adobe.

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Please submit your completed form with all required approvals and documentation to the appropriate Office of Ethics Advisor. View the full listing of Office of Ethics Advisors

Research, Education and Economics (REE) agencies (ARS, ERS, NASS and NIFA) contact your Ethics Advisors here: Office of Ethics Advisors for REE (PDF, 150 KB)

FINANCIAL DISCLOSURE FORMS

FORM #	DESCRIPTION	AVAILABLE FORMATS
OGE-278	Senate-confirmed Presidential appointees, all SES employees (and equivalent) and all Schedule C staff are required to file the OGE 278e Public Financial Disclosure report within 30 days of entering and leaving a position at USDA, as well as annually while serving in a covered position. Annual reports, covering the previous calendar year, are due each year by May 15th, unless you obtain an extension to file. Incumbent filers submit reports electronically using the Office of Ethics FDonline electronic filing system at fd.intelliworxit.com/client. Effective January 2017, New Entrant filers must submit the OGE 278 electronically using Integrity at www.integrity.gov. Please email DAEO.Ethics@oe.usda.gov for account setup and access. The Stop Trading on Congressional Knowledge (STOCK) Act requires OGE-278 Public Financial Disclosure Report filers to submit a Periodic Transaction Report (OGE-278-T) to report certain financial transactions. Incumbent filers designated before January 1, 2017: Submit your OGE 278-T using FDonline at fd.intelliworxit.com/client. Filers designated on or after January 1, 2017: Submit your OGE 278-T using Integrity at www.integrity.gov	Submit all OGE 278 Public Financial Disclosure reports electronically. Incumbent filers designated before January 1, 2017: Submit your report using FDonline at: fd.intelliworxit.com/client Filers designated on or after January 1, 2017: Submit your report using Integrity at: www.integrity.gov.
OGE 450	Career staff classified at GS-15 or below may be required to file the OGE 450 Confidential Financial Disclosure Report if your agency concludes that your job duties and responsibilities require you to file. New Entrant reports are due within 30 days of an employee entering a covered position. Annual reports cover a calendar year and are due each year by February 15th, unless you obtain an extension to file. Submit the OGE 450 electronically using the Office of Ethics FDonline filing system. New Entrant filers: Please contact your Ethics Advisor for account setup and system access.	Submit all OGE 450 and OGE 450-A reports electronically using FDonline at: fd.intelliworxit.com/client Note: Effective January 1, 2019, the OGE Optional Form 450-A, Confidential Certificate of No New Interests, is not an accepted alternate form for the OGE-450 annual report, per US Office of Government Ethics regulation 5 CFR § 2634.905. This means USDA confidential financial disclosure filers may not file the OGE 450-A in lieu of the OGE 450. Effective January 1, 2019, all USDA annual confidential financial disclosure filers must file a complete OGE 450.

FORM #

DESCRIPTION

AVAILABLE FORMATS

OGE-278

Senate-confirmed Presidential appointees, all SES employees (and equivalent) and all Schedule C staff are required to file the OGE 278e Public Financial Disclosure report within 30 days of entering and leaving a position at USDA, as well as annually while serving in a covered position. Annual reports, covering the previous calendar year, are due each year by May 15th, unless you obtain an extension to file. Incumbent filers submit reports electronically using the Office of Ethics FDonline electronic filing system at fd.intelliworxit.com/client. Effective January 2017, New Entrant filers must submit the OGE 278 electronically using Integrity at www.integrity.gov. Please email DAEO.Ethics@oe.usda.gov for account setup and access.

The Stop Trading on Congressional Knowledge (STOCK) Act requires OGE-278 Public Financial Disclosure Report filers to submit a Periodic Transaction Report (OGE-278-T) to report certain financial transactions. Incumbent filers designated before January 1, 2017: Submit your OGE 278-T using FDonline at fd.intelliworxit.com/client.

Filers designated on or after January 1, 2017: Submit your OGE 278-T using Integrity at www.integrity.gov

Submit all OGE 278 Public Financial Disclosure reports electronically.

Incumbent filers designated before January 1, 2017: Submit your report using FDonline at: fd.intelliworxit.com/client

Filers designated on or after January 1, 2017: Submit your report using Integrity at: www.integrity.gov.

OGE 450

Career staff classified at GS-15 or below may be required to file the OGE 450 Confidential Financial Disclosure Report if your agency concludes that your job duties and responsibilities require you to file. New Entrant reports are due within 30 days of an employee entering a covered position. Annual reports cover a calendar year and are due each year by February 15th, unless you obtain an extension to file.

Submit the OGE 450 electronically using the Office of Ethics FDonline filing system. New Entrant filers: Please contact your Ethics Advisor for account setup and system access.

Submit all OGE 450 and OGE 450-A reports electronically using FDonline at: fd.intelliworxit.com/client

Note: Effective January 1, 2019, the OGE Optional Form 450-A, Confidential Certificate of No New Interests, is not an accepted alternate form for the OGE-450 annual report, per US Office of Government Ethics regulation 5 CFR § 2634.905. This means USDA confidential financial disclosure filers may not file the OGE 450-A in lieu of the OGE 450. Effective January 1, 2019, all USDA annual confidential financial disclosure filers must file a complete OGE 450.

REQUEST FOR DOCUMENTS

FORM #	DESCRIPTION	AVAILABLE FORMATS
OGE-201	Request for Copy of a Completed Public Disclosure Report	PDF (PDF, 311 KB)

TRAVEL

FORM #	DESCRIPTION	AVAILABLE FORMATS
AD-1101	Approval and Report of Travel Funds Received from Non-Federal Sources for use by a prospective traveler.	PDF (PDF, 292 KB)
	Sample Letter of Acceptance for Travel Funds Provided by a Non-Federal Source	MS Word (DOC, 29.5 KB)
SF-326	Semi-annual Report of Payments Accepted from a Non-Federal Source for use by ethics official charged with documenting travel assistance accepted under 31 U.S.C. 1353.	MS Excel PDF (PDF, 65.3 KB)

FORM #

DESCRIPTION

AVAILABLE FORMATS

AD-1101

Approval and Report of Travel Funds Received from Non-Federal Sources for use by a prospective traveler.

PDF (PDF, 292 KB)

Sample Letter of Acceptance for Travel Funds Provided by a Non-Federal Source

MS Word (DOC, 29.5 KB)

SF-326

Semi-annual Report of Payments Accepted from a Non-Federal Source for use by ethics official charged with documenting travel assistance accepted under 31 U.S.C. 1353.

MS Excel

PDF (PDF, 65.3 KB)

AWARDS & DEGREES

FORM #	DESCRIPTION	AVAILABLE FORMATS
	Review / Approval of Outside Awards	PDF (PDF, 54.5 KB)
	Review / Approval of Honorary Degrees	PDF (PDF, 30.0 KB)

OUTSIDE EMPLOYMENT & ACTIVITIES

FORM #	DESCRIPTION	AVAILABLE FORMATS
OE-101	Review/Approval of Non-Federal Employment or Activity Form for use with USDA Supplemental Ethics Regulation, 5 CFR Part 8301. Prior to submitting a request for non-Federal employment, view guidance under Rules of the Road, specifically the Standards of Ethical Conduct (5 CFR 2635.401-.403; .501-.503; .701-.705; and .801-809).	PDF
OE-101 (Farm)	Office of Ethics – Farm, Conservation, & Rural Programs Branch Guidance: Request for Prior Approval of Outside Activity / Employment for use by employees of FSA, NRCS, and RD in connection with requests for outside employment pursuant to the USDA Supplemental Ethics Regulation, 5 CFR Part 8301.	PDF (PDF, 607 KB)
OE-101 (USFS)	Office of Ethics – Forest Service Guidance: Request for Prior Approval of Outside Activity / Employment for use by employees of the Forest Service in connection with with requests for outside employment pursuant to the USDA Supplemental Ethics Regulation, 5 CFR Part 8301.	PDF (PDF, 1.2 MB)
OE-101 (Marketing)	Office of Ethics – Marketing, Regulatory, and Nutrition Branch Guidance: Request for Prior Approval of Outside Activity / Employment for use by employees of AMS, APHIS, GIPSA, FNS, FSIS and NAD employees in connection with requests for outside employment pursuant to the USDA Supplemental Ethics Regulation, 5 CFR Part 8301.	PDF
OE-101 (REE)	Office of Ethics – Research, Education & Economics Guidance: Request for Prior Approval of Outside Activity / Employment for use by employees of ARS, ERS, NASS and NIFA in connection with requests for outside employment pursuant to the USDA Supplemental Ethics Regulation, 5 CFR Part 8301.	PDF (PDF, 1.0 MB) Instructions (PDF, 318 KB)
STOCK ACT	Notification to the Agency Ethics Office about Post-Employment Negotiation: USDA public financial disclosure (OGE 278) filers must file this form with the Office of Ethics within 3 business days of commencing negotiation for or agreement of future employment or compensation with a non-federal entity.	PDF

OUTSIDE ORGANIZATIONS

FORM #	DESCRIPTION	AVAILABLE FORMATS
	Appointment as Agency Liaison Memorandum	PDF (PDF, 21.1 KB)
OE-208	Request for Approval to Serve as an Officer, Director, or Trustee of a Nonprofit Professional Organization in an Official Capacity	PDF

COMBINED FEDERAL CAMPAIGN

FORM #	DESCRIPTION	AVAILABLE FORMATS
OE-109	ETHICS AND THE COMBINED FEDERAL CAMPAIGN (CFC) – IMPORTANT NEW CHANGE IN 2017. Due to a change in the OPM regulations regarding the Combined Federal Campaign (CFC), effective January 1, 2017, the solicitation and collection of cash donations in connection with CFC are strictly prohibited. This means that, for the current and all future campaigns, cash fundraising events, such as bake sales, silent auctions, book sales, chili cook-offs, and other similar events, are no longer permitted in connection with the CFC. Instead CFC special events must focus only on increasing employee awareness of CFC charities and their missions.	For a complete set of the new CFC rules, you can visit the Electronic Code of Federal Regulations (see section 950.502(b) for the new rule concerning solicitation methods).

FORM #

DESCRIPTION

AVAILABLE FORMATS

OE-109

ETHICS AND THE COMBINED FEDERAL CAMPAIGN (CFC) – IMPORTANT NEW CHANGE IN 2017. Due to a change in the OPM regulations regarding the Combined Federal Campaign (CFC), effective January 1, 2017, the solicitation and collection of cash donations in connection with CFC are strictly prohibited. This means that, for the current and all future campaigns, cash fundraising events, such as bake sales, silent auctions, book sales, chili cook-offs, and other similar events, are no longer permitted in connection with the CFC. Instead CFC special events must focus only on increasing employee awareness of CFC charities and their missions.

For a complete set of the new CFC rules, you can visit the Electronic Code of Federal Regulations (see section 950.502(b) for the new rule concerning solicitation methods).

Agency-Specific Forms For Employees of the Research, Education and Economics Agencies (ARS, ERS, NASS & NIFA)

FORM #	FORM TITLE	AVAILABLE FORMATS
SEB-102	Conflict of Interest Certification	Adobe PDF (PDF, 262 KB)
SEB-103	Request for Approval to Accept an Award from a Non-Federal Source	Adobe PDF (PDF, 188 KB)
SEB-104	Acceptance of Free Attendance at Widely-Attended Gatherings	Adobe PDF (PDF, 250 KB)
SEB-106	Request for Approval of Official Duty Activity	Adobe PDF (PDF, 160 KB)
	Certification of U.S. Government Material as Public Domain Content	MS Word (DOC, 32 KB)
	Disqualification Memorandum – Outside Activity	MS Word (DOC, 26 KB)
	Disqualification Memorandum – Stock Holdings	MS Word (DOC, 26 KB)
	Disqualification Memorandum – Seeking Employment	MS Word
	Federal Liaison Memorandum Template	MS Word (DOCX, 24.8 KB)