Commission Forms

Required of State officers and employees designated as policy-makers whose intended outside activity requires both their agency Ethics Officer and Commission on Ethics and Lobbying approval. Revised 12/19/2022

State officers and employees, and statewide elected officials, are required to request and receive approval from their Approving Authority before accepting an official activity expense payment or service payment (as those terms are defined in 19 NYCRR Part 931 of the Commission regulations).

Updated 6/30/22

State officers and employees, and statewide elected officials, are required to request and receive approval from their Approving Authority before accepting an honorarium (when allowed by statute and as that term is defined in 19 NYCRR Part 930 of the Commission's regulations).

Revised 4/13/2023

The Commission on Ethics and Lobbying in Government encourages all filers to submit their FDS through the FDS Online Filing System. However, individuals who submit a paper filing in lieu of an electronic filing may complete this writable PDF form. 

A filer required to file both an annual disclosure report with the New York City Conflict of Interests Board (COIB) and a FDS with the Commission on Ethics and Lobbying in Government may be able to submit the COIB filing to the Commission along with completing and submitting this supplemental form.

The Commission on Ethics and Lobbying in Government encourages all filers to submit a FDS through the FDS Online Filing System. However, individuals who submit a paper filing in lieu of an electronic filing may complete this writable PDF form. 

A filer required to file both an annual disclosure report with the New York City Conflict of Interests Board (COIB) and a FDS with the Commission on Ethics and Lobbying in Government may be able to submit the COIB filing to the Commission along with completing and submitting this supplemental form.

Questions 1 - 3: Name, position, family

Question 4(a) (Individual): Positions of Authority (other than those with the State) 

Question 8(b-1)

Revised July 5, 2022

Questions 1 - 3: Name, position, family

Question 4(a) (Individual): Positions of Authority (other than those with the State) 

Question 4(b) (Spouse and Unemancipated Child): Positions of Authority (other than those with the State) 

Question 5(a) (Individual): Other Occupation/Outside Employment

Question 5(b) (Spouse and Unemancipated Child): Other Occupation/Outside Employment

Question 6: Interests and Contracts with a State or local government

Question 7: Political Party Positions and Activities

Question 8(a): Licensed Professions

Question 8(b-1)

Question 8(b-2)(i)

Question 8(b-2)(ii)

Question 8(c)

Question 9: Gifts

Question 10: Reimbursements by non-governmental sources related to Official State Duties

Question 11: Retirement, Trusts, Estates

Question 12(a): Employment Agreements

Question 12(b): Employment Agreements - Prior Employment

Question 13: All non-State income

Question 14: Deferred Income

Question 15: Assignment of income or transfer of assets

Question 16: Investments in Securities

Question 17: Real Estate

Question 18: Money due or Notes and Accounts Receivable

Question 19:  Debts and Liabilities

Question 20: Signature Line

A filer who is not designated as a policymaker and whose annual salary exceeds the SG-24 filing rate may request an exemption from filing a FDS. Such exemptions may be requested through the FDS Online Filing System or by completing and submitting this writeable PDF form, which must be received or postmarked on or before the filing due date.

State agencies and labor unions may request an exemption from filing a FDS on behalf of individuals in the same title or job classification who are not designated as policy makers and whose annual salary exceeds the SG-24 filing rate. Such exemptions may be requested through the FDS Online Filing System or by completing and submitting this writeable PDF form, which must be received or postmarked on or before the filing due date.

A filer may request a 45-day extension of time to file the FDS based on justifiable cause or undue hardship. Extensions may be requested through the FDS Online Filing System or by completing and submitting this writeable PDF form, which must be received or postmarked on or before the filing due date.

A filer may apply to the NYS Commission on Ethics and Lobbying in Government for deletion of specific information from public inspection or exemption from reporting certain information regarding a spouse or child.

This form is available for State officers and employees who have left State service and would like to request a copy of previously filed FDS.  Please note: this form must be notarized. 

Revised July 5, 2022

A filer may request redaction of specific information from the copy of his or her FDS that is made publicly available. Redactions may be requested through the FDS Online Filing System or by completing and submitting this writeable PDF form. The Commission on Ethics and Lobbying in Government, at its discretion, may grant the request if the information sought to be redacted has no material bearing on the discharge of the filer’s official duties. This form may also be used to request an exemption from disclosing certain information pertaining to a spouse and/or unemancipated children. Again, at its discretion, the Commission may grant the request if (1) the spouse, on his or her own behalf or on behalf of an unemancipated child, objects to the disclosure of such information, and (2) the information has no bearing on the discharge of the filer's official duties. 

Revised July 5, 2022

Revised 4/4/19

Please use this pre-formatted Excel Spreadsheet to disclose information on Sources for Source of Funding.  Before completing the pre-formatted Excel Spreadsheet, Paper Filers who need the Source of Funding Summary Statement Form should contact the Lobbying Help Desk at (518) 474-3973 or [email protected] for assistance.

ONLINE FILERS who meet the Expenditure Threshold and are required to disclose Source of Funding (“SoF”) information must either: utilize the Commission's online Lobbying Application (“LA”) to data-enter each Source individually; or complete and upload the pre-formatted Excel Spreadsheet provided by the Commission on Ethics and Lobbying. 

Refer to the 'Instructions for Completing the Pre-formatted Excel Spreadsheet to Disclose Source of Funding Information' prior to completing the blank spreadsheet.

Please note - this spreadsheet will not immediately appear on your screen; it will be automatically download and appear in your 'downloads' folder, or at the bottom of your screen. 

This form may be submitted with a Statement of Registration in lieu of a copy of a lobbying agreement or contract.

Revised 11/10/2023

This form may be submitted with a Statement of Registration in lieu of a copy of a lobbying agreement or contract.  

Revised 11/15/2023

This form may be used by a Retained Lobbyist who is prepared to register with the Commission, but has not received the signed (executed) Lobbying Agreement back from your Client.

Instructions revised 6/4/2024

Use this sample written authorization letter for filing years 2024 through 2019.

Revised 12/3/2024

Use this sample written authorization letter for Employed Lobbyists for filing years 2024 through 2019.

Revised 12/3/2024

This sample letter advises the Commission of a change in the terms of an agreement/authorization for filing years 2024 through 2019.

Revised 10/20/22

Sample letter to assist Filers in terminating an Individual Lobbyist from an Organization Profile related to 2019 and later year filings.  

For Paper PDF Filers only.  Filers that utilize the online Lobbying Application must terminate Individual Lobbyists online. 

Revised 11/2/2022

Use this letter as a sample letter for Client Terminations related to 2019 and later year filings. 

Revised 11/2/2022