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Vendor Ownership Information Form

Illinois Public Act 102-0265 was approved in August 2021 requiring the Village of Glen Ellyn to collect “Status of Ownership” information. 

Printable Form

You may print this form, fill it out and mail or e-mail it to gevendors@glenellyn.org. 

Vendor Ownership Information Form

  1. Application Type*
  2. Status of Ownership (select at least one)*

    Information is collected for reporting purposes only and not vendor selection. Please check any or all of the following that apply to the ownership of your firm. 

  3. How are you certifying?*
  4. By submitting this form you hereby certify that the information supplied is true and correct.

  5. Leave This Blank:

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