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Get Employee's Statement

IMPORTANT NOTICE: Completion of this form is necessary to accomplish the requirements outlined in 225 ILCS 446/1 et. seq. (Illinois Compiled Statutes). Disclosure of this information is REQUIRED.

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How to fill out the employee's statement online

Completing the employee's statement is essential for fulfilling the requirements outlined in Illinois Compiled Statutes. This guide provides step-by-step instructions to help users navigate the online completion process with confidence.

Follow the steps to successfully complete the employee's statement.

  1. Click 'Get Form' button to access the document and open it in a suitable editor for your needs.
  2. Begin by entering your employee number in the designated field. This number is typically assigned by your employing agency.
  3. Fill in the name and address of the employing agency. Ensure accuracy to prevent any processing delays.
  4. Provide your full name as the employee. This should match the name on your official identification.
  5. Input your date of employment. This is the date you started working with the agency.
  6. Enter your social security number carefully. This information is crucial for identity verification.
  7. Complete your current address, including street, city, state, and zip code, ensuring all details are correct.
  8. Fill in your date of birth in the format Month/Day/Year.
  9. Provide your place of birth as requested in the corresponding field.
  10. Indicate whether you have ever been dishonorably discharged from the armed services by selecting 'Yes' or 'No.'
  11. Answer the question regarding any past criminal convictions. If applicable, include a detailed explanation of the offense and its final outcome.
  12. State whether you have been declared incompetent by any court due to mental or physical reasons. An explanation is required if the answer is 'Yes.'
  13. Provide information regarding any history of habitual drunkenness or narcotic dependence, with an explanation if you answer 'Yes.'
  14. Answer the question regarding any certificate denial related to the Private Detective Act. Fill in details if applicable.
  15. Detail your business or occupation for the last five years, including locations and employer names.
  16. Finally, input the date of completion, sign, and ensure all information is accurate before submission.
  17. Once completely filled out, you can save the changes, download, print, or share the form as needed.

Complete the employee's statement online to meet your agency’s requirements efficiently.

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