Office of Ethics
United States Department of Agriculture

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.

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

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 https://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 https://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: https://fd.intelliworxit.com/client/

Filers designated on or after January 1, 2017: Submit your report using Integrity at: www.Integrity.gov.
OGE 450 and 450A Career staff classified at GS-15 or below may be required to file the OGE 450 Confidential Financial Disclosure Report (or OGE Optional Form 450-A) 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:

https://fd.intelliworxit.com/client/

REQUEST FOR DOCUMENTS

FORM # DESCRIPTION AVAILABLE FORMATS
OGE-201 Request for Copy of a Completed Public Disclosure Report


TRAVEL

FORM # DESCRIPTION AVAILABLE FORMATS
AD-1101 Approval and Report of Travel Funds Received from Non-Federal Sources for use by a prospective traveler.
  Sample Letter of Acceptance for Travel Funds Provided by a Non-Federal Source
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.


AWARDS & DEGREES

FORM # DESCRIPTION AVAILABLE FORMATS
  Review / Approval of Outside Awards PDF
  Review / Approval of Honorary Degrees PDF


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
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
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

Instructions


OUTSIDE ORGANIZATIONS

FORM # DESCRIPTION AVAILABLE FORMATS
  Appointment as Agency Liaison Memorandum PDF
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).

 

AGENCY-SPECIFIC FORMS FOR EMPLOYEES OF THE RESEARCH, EDUCATION AND ECONOMICS AGENCIES (ARS, ERS, NASS & NIFA):
FORM # FORM TITLE AVAILABLE FORMATS
AD-1101 Acceptance of Travel Funds from a Non-Federal Source Instructions Adobe PDF
OE-101 Request for Approval of Outside Activity Instructions Adobe PDF
SEB-102 Conflict of Interest Certification Adobe PDF
SEB-103 Request for Approval to Accept an Award from a Non-Federal Source Adobe PDF
SEB-104 Acceptance of Free Attendance at Widely-Attended Gatherings Adobe PDF
SEB-106 Request for Approval of Official Duty Activity   Adobe PDF

 

FORM # DESCRIPTION AVAILABLE FORMATS
  Certification of U.S. Government Material as Public Domain Content MS Word  
  Disqualification Memorandum – Outside Activity MS Word  
  Disqualification Memorandum – Stock Holdings MS Word  
  Disqualification Memorandum – Seeking Employment MS Word  
  Federal Liaison Memorandum Template MS Word