N.J. Admin. Code § 19:61-6.10

Current through Register Vol. 56, No. 21, November 4, 2024

Section 19:61-6.10 - Annual disclosure for scholarly capacity employees

(a) A State official serving in a scholarly capacity shall disclose annually to his or her department head any travel, subsistence or entertainment expenses, honoraria, academic prizes, or other things of value related to activities performed in his or her scholarly capacity received in the prior academic year (July 1st through June 30th). The sources of all such expenses and things of value shall be identified.

(b) A State official serving in a scholarly capacity shall use the following form for his or her annual disclosure. The completed forms shall be submitted to his or her department head, and the form shall be kept on file for a period of five years. Each State college and university shall forward copies of the forms to the Commission on an annual basis.

Annual College and University Disclosure Form

Date of Statement___________

For Academic Year July 1, ___ through June 30, ________

First Name _________________________________________________

Last Name _________________________________________________

Institution _________________________________________________

Department ________________________________________________

Position ___________________________________________________

Daytime Telephone __________________________________________

Email Address ______________________________________________

Instructions: This form must be submitted pursuant to 19:61-6.1 0(a), which requires a State official serving in a scholarly capacity to annually disclose to his/her Department head any travel, subsistence or entertainment expenses, honoraria, academic prizes or other things of value related to activities performed in a scholarly capacity received in the prior academic year (July 1st through June 30th). Any benefit received related to your State position, and any outside activity performed, while not acting in a scholarly capacity, must still be reported pursuant to your institution's procedures, and on the forms required by the State Ethics Commission. Enter "N/A" in any category in which you did not receive benefits while acting in scholarly capacity during the covered academic year.

Benefits Received

A. Travel, Subsistence and Entertainment Expenses

Date Received Type of Benefit Amount Source Interested Party*

1.

2.

3.

4.

B. Honoraria, Academic Prizes or Other Things of Value

Date Received Type of Benefit Amount Source Interested Party*

1.

2.

3.

4.

*Indicate whether the source of the benefit is an interested party to your institution. "Interested party" means: 1) any person or entity your institution regulates, licenses or supervises; 2) any grantee or grantor to your institution and any employee, representative or agent thereof; 3) any supplier/vendor to your institution; 4) any advocacy group that advocates or represents the positions of its members to your institution; 5) any organization a majority of whose members fall under 1-4 above.

C. Assigned Educational Texts or Materials

1. Do you assign educational books or materials authored by you as a course requirement?

Yes_____ No______

2. If answer to question 1 is yes, do you receive royalties from those educational materials?

Yes_____ No______

3. If answer to question 2 is yes, did you donate those royalties?

Yes______ No______

4. If answer to 3 is yes, where were the royalties donated?

__________________________________________________________

To the best of my knowledge and belief the information on this form is true and accurate.

EMPLOYEE: _____________________________ Date:____________

Signature

I have reviewed the information contained on this form.

DEPARTMENT HEAD: ______________________ Date:__________

Signature

ETHICS

LIAISON OFFICER: _______________________Date:____________

Signature

N.J. Admin. Code § 19:61-6.10

New Rule, R.2004 d.390, effective 10/18/2004.
See: 36 N.J.R. 2316(a), 36 N.J.R. 4842(a).
Amended by R.2006 d.292, effective 8/21/2006.
See: 38 N.J.R. 1804(a), 38 N.J.R. 3318(a).
In (b) and (d), deleted the last sentence.
Repealed by R.2007 d.67, effective 2/20/2007.
See: 38 N.J.R. 4685(a), 39 N.J.R. 670(a).
Section was "Solicitation or acceptance of a thing of value from an entity other than an interested party".
New Rule, R.2007 d.357, effective 11/19/2007.
See: 39 N.J.R. 3286(a), 39 N.J.R. 4951(a).
Amended by R.2010 d.283, effective 12/6/2010.
See: 42 N.J.R. 1014(a), 42 N.J.R. 2980(a).
In (a), substituted "academic" for "calendar" and inserted "(July 1st through June 30th)"; in the introductory paragraph of (b), substituted "on an annual basis" for "annually, at the end of a each January", and rewrote the disclosure form.
Amended by R.2012 d.045, effective 2/21/2012.
See: 43 N.J.R. 1515(a), 44 N.J.R. 519(a).
Section was "Annual disclosure".