OGE Form 201 Request an Individual's Ethics Documents

Form approved OMB No. 3209-0002
Form expires 4/30/XX
OGE Form 201

Supplemental Information

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Whose ethics documents are available to request from OGE?
Approximately 26,000 executive branch employees file public financial disclosure reports. OGE is responsible
for making the disclosures and related ethics documents available for about 1,000 of these individuals who
occupy particularly sensitive positions.
You can request ethics documents from OGE for individuals who are:
(1)
Presidentially appointed and Senate-confirmed;
(2)
a Presidential or Vice Presidential candidate;
(3)
a senior official at the White House;
(4)
a Designated Agency Ethics Official.
You can also request copies of certificates of divestiture issued to anyone in the executive branch.

Whose ethics documents are available to request from executive branch departments and
agencies?
If you are looking for the ethics documents of an individual who is NOT (1) Presidentially appointed and Senateconfirmed, (2) a Presidential or Vice Presidential candidate, (3) a senior official at the White House, or (4) a Designated
Agency Ethics Official, you must submit a request to the agency that employs the individual.
To make a request for ethics documents to the individual’s employing agency, submit this Form to the agency using the
contact information on this page.

What documents can be requested?
You can use this Form to request copies of the financial disclosure reports and other records, as specified in the table
below, of certain executive branch officials. These records are available under the Ethics in Government Act of 1978
("the Act"), the Stop Trading on Congressional Knowledge Act of 2012 (STOCK Act), and OGE's implementing
regulations. Copies of public financial disclosure reports (278e) and periodic transaction reports (278T) are available by
request 30 days after the individual files the report.

Should I use the online system or fill out the PDF Form?
If you are requesting ethics documents from OGE, you should use the online system whenever possible. If you are
unable to use the online system for your request, e-mail the PDF Form to 201forms@oge.gov or mail the PDF Form to:
U.S. Office of Government Ethics
1201 New York Avenue, NW., Suite 500
Washington DC 20005-3917
(Note: Currently OGE is unable to fill any request using the PDF Form that does not provide an email address for the
requestor.)
If you are requesting ethics documents from another agency, you may fill out the PDF Form and submit it to the
relevant agency using the contact information on this page. (Agencies may use other systems or forms to accept
requests.)
You may also use the PDF Form to request certain other records from OGE, as specified in this table.

ETHICS DOCUMENTS
Public Financial Disclosure Report
(OGE Form 278e) – Candidate
Public Financial Disclosure Report
(OGE Form 278e) – New Entrant
Public Financial Disclosure Report
(OGE Form 278e) - Nominee
Public Financial Disclosure Report
(OGE Form 278e) - Annual
Public Financial Disclosure Report
(OGE Form 278e) – Termination
Periodic Transaction Reports
(OGE Form 278-T)
Certificates of Divestiture
18 U.S.C. § 208(b)(1) & (b)(3) waivers

Cover Letters

Ethics in Government Act qualified blind
trust and qualified diversified trust
instruments

Other OGE Form 201 requests for access

DESCRIPTION
Details the personal financial interests of the filer, the filer’s spouse, and
any dependent children. These reports are filed by candidates for the
office of the President and Vice President.*
Details the personal financial interests of the filer, the filer’s spouse, and
any dependent children. These reports are filed within 30 days of taking
office.*
Details the personal financial interests of the filer, the filer’s spouse, and
any dependent children. These reports are filed at the time of
nomination for Senate-confirmed positions.
Details the personal financial interests of the filer, the filer’s spouse, and
any dependent children. These reports are filed by all public filers on
May 15th of each year.*
Details the personal financial interests of the filer, the filer’s spouse, and
any dependent children. These reports are filed by all public filers within
30 days of leaving a public filing position.*
Provides information about the purchase, sale, or exchange of securities
and similar assets throughout the year.*
Allows an eligible person to defer paying capital gains on property sold
to comply with conflict of interest requirements.
Waivers are available after deletion of any material withholdable
pursuant to the Freedom of Information Act, 5 U.S.C. § 552 (see 18
U.S.C. § 208(d)(1)).
There are two types of cover letters available:
1. Cover letters for approved public reporting waiver requests for
certain special government employees who work less than 130 days in a
calendar year.
2. Cover letters for approved gifts reporting waiver requests.
Qualified blind trust and qualified diversified trust instruments (other
than those provisions which relate to the testamentary disposition of
the trust assets), the list of assets transferred to such trusts (and of
assets sold in the case of a qualified blind trust), as well as, in the case
of trust dissolution, the report thereon and the list of trust assets at that
time, and the certificates of independence and compliance with respect
to qualified trusts.
Includes the name and required information provided by previous OGE
Form 201 applicants.

* An agency may grant an extension of the filing deadline for “good cause shown,” provided such extensions do not
exceed 90 days (180 days for a filer serving in a combat zone).

OGE Form 201

Request an Individual’s Ethics Documents

To Supplemental Information

I. Application
1. Your name (required):
1a. Your mailing address or email address (required): 1b. Your telephone number (required):
2. Your occupation (required):
3. Is this application for or on behalf of any other person or organization (required)?

Yes

No

3a. If yes, provide the name and address of the person or organization (required):

4.Type of applicant:

News media

Member of the public

Public interest group

Private organization

Government

Other

5. Name of individual(s) whose documents are requested (use the continuation page if needed):

Go to Continuation Page
5a. A copy of the most recent OGE 278e will be provided unless you specify below which documents (with time
period) that you are requesting. (e.g. Nominee report and 20XX annual report filed by the above individual; 18 U.S.C. § 208(b)
(1) waivers issued to the above individual(s) from 1/1/20XX-present; All 278T reports filed by the listed individual(s) during
February 20XX)

6. Indicate how you wish to receive your response:

By email (at the email address listed above)
By mail (at the address listed above)

I am aware that in completing this official government form that any intentionally false or misleading statement, certification, or response
provided in this form is a violation of law punishable by a fine or imprisonment, or both, under 18 U.S.C. § 1001. Pursuant to section 105(d) of
the Ethics in Government Act of 1978, as amended, and 5 C.F.R. § 2634.603(f) of the implementing OGE regulation, it is unlawful for any
person to obtain or use a report:
(1)
for any unlawful purpose;
(2)
for any commercial purpose, other than by news and communications media for dissemination to the general public;
(3)
for determining or establishing the credit rating of any individual; or
(4)
for use, directly or indirectly, in the solicitation of money for any political, charitable, or other purpose.
The U.S. Attorney General may bring a civil action against any person who obtains or uses a report for any such prohibited purpose as set forth
above. The court may assess against such a person a penalty in any amount not to exceed $23,727. Such remedy shall be in addition to any
other remedy available under statutory or common law.

7. Applicant's Signature:

Date:

II. Notice of Action
Your request does not comply with the requirements of the statute. Please complete Part I of this Form and return so
we may complete your request.
Your request requires you to pay a fee in the following amount before it will be processed:
(When fees are required, make out a check payable to the U.S. Treasury and send it to the executive branch agency processing
this request Form.)

Agency Use Only (Optional)
Filled

Not Filled

Additional Notes:

Date Received:

A. Privacy Act Statement
Sections 105 and 402(b)(1) of the Ethics in Government Act, as amended (5 U.S.C. §§ 13107 and 13122(b)(1)) and 5 C.F.R. § 2634.603 authorize the solicitation of the information
requested in this form. The primary use of the information on this form is to permit officials of the recipient agency to consider and process requests for inspection or receipt of
copies of the OGE Form 278e Executive Branch Personnel Public Financial Disclosure Report and OGE Form 278-T Periodic Transaction Report, or other covered records to which
you seek access. Furnishing the requested information is voluntary. However, failure to furnish this information will result in the recipient agency’s inability to allow access to, or
to provide a copy/copies of, the financial disclosure report(s) or other record(s) requested. Information on the form itself may be publicly disclosed pursuant to a proper request
under section 105(b) of the Ethics in Government Act (5 U.S.C. § 13107(b)) or as otherwise authorized by law. Additional disclosures of the information on this form may be made
pursuant to the routine uses set forth in the OGE/GOVT-1 Privacy Act system of records:
(1) to any requesting person, subject to the limitation contained in section 208(d)(1) of title 18, any determination granting an exemption pursuant to sections 208(b)(1)
and 208(b)(3) of title 18;
(2) to a Federal, State, or local law enforcement agency if the disclosing agency becomes aware of violations or potential violations of law or regulation;
(3) to a source when necessary to obtain information relevant to a conflict of interest investigation or determination;
(4) to the National Archives and Records Administration or the General Services Administration in records management inspections;
(5) to the Office of Management and Budget during legislative coordination on private relief legislation;
(6) when the disclosing agency determines that the records are arguably relevant to a proceeding before a court, grand jury, or administrative or adjudicative body; or in a proceeding
before an administrative or adjudicative body when the adjudicator determines the records to be relevant to the proceeding;
(7) to reviewing officials in a new office, department or agency when an employee transfers or is detailed from one covered position to another;
(8) to a Member of Congress or a congressional office in response to an inquiry made on behalf of, and at the request of, an individual who is the subject of the record;
(9) to contractors and other non-Government employees working on a contract, service, or assignment for the Federal Government when necessary to accomplish a function
related to this OGE Governmentwide system of records;
(10) on the OGE Website and to any person, department or agency, any written ethics agreements filed with OGE by an individual nominated by the President to a position
requiring Senate confirmation;
(11) on the OGE website and to otherwise disclose to any person, including other departments and agencies, any certificate of divestiture issued by the Office of Government Ethics,
pursuant to 26 U.S.C. 1043;
(12) on the OGE website and to otherwise disclose to any person, including other departments and agencies, any waiver issued by the President or the President’s designee of
the restrictions contained in Executive Order 13770 “Ethics Commitments by Executive Branch Appointees” (January 28, 2017) or any superseding Executive order;
(13) to appropriate agencies, entities, and persons when: (1) the agency maintaining the records suspects or has confirmed that there has been a breach of the system of records;
(2) the agency maintaining the records has determined that as a result of the suspected or confirmed breach there is a risk of harm to individuals, the agency (including its
information systems, programs, and operations), the Federal Government, or national security; and (3) the disclosure made to such agencies, entities, and persons is reasonably
necessary to assist in connection with the agency's efforts to respond to the suspected or confirmed breach or to prevent, minimize, or remedy such harm; and
(14) to another Federal agency or Federal entity, when the agency maintaining the record determines that information from this system of records is reasonably necessary to assist
the recipient agency or entity in (1) responding to a suspected or confirmed breach or (2) preventing, minimizing, or remedying the risk of harm to individuals, the recipient
agency or entity (including its information systems, programs, and operations), the Federal Government, or national security, resulting from a suspected or confirmed breach.
See also OGE/GOVT-1 Executive Branch Personnel Public Financial Disclosure Reports and Other Name-Retrieved Ethics Program Records.

B. Public Burden Information
Public burden reporting for this collection of information is estimated to take approximately ten minutes per response, including time for reviewing instructions, gathering and
maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to Program Counsel, U.S. Office of Government Ethics, Suite 500, 1201 New York Avenue, NW., Washington DC
20005-3917. Do not file this form with this official; rather, file it with the appropriate office of the executive branch department or agency from which you are seeking access to a
financial disclosure report or other covered records.
Pursuant to the Paperwork Reduction Act, as amended, an agency may not conduct or sponsor, and no person is required to respond to, a collection of information unless it
displays a currently valid OMB control number (that number, 3209-0002, is displayed here and in the upper right-hand corner of the front page of this OGE Form 201).

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Continuation Page
Name of individual(s) whose documents are requested (continued)

A copy of the most recent OGE 278e will be provided unless you specify below which documents (with time period)
that you are requesting. (e.g. Nominee report and 20XX annual report filed by the above individual; 18 U.S.C. § 208(b)(1) waivers

issued to the above individual(s) from 1/1/20XX-present; All 278T reports filed by the listed individual(s) during February 20XX)