N.J. Admin. Code § 19:61-6.8

Current through Register Vol. 56, No. 21, November 4, 2024
Section 19:61-6.8 - Approval request form

State officials shall use the following form to request approval to attend events.

REQUEST FOR APPROVAL FOR

ATTENDANCE AT EVENT

DEPARTMENT OF _________________________________________

Name _____________________ Division ________________________

Title __________________ Telephone ___________ FAX __________

E-mail address ______________________________________________

Event _____________________________________________________

Sponsor ___________________________________________________

Is the sponsor an "interested party"? Yes ____ No ____ "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.

Is the State official a speaker, panel participant or resource person?

Yes _____ No ____

Is the sponsor an agency of the federal government, one or more other states or a political subdivision thereof? Yes _____ No _____

Is the sponsor a nonprofit organization? Yes ______No ______

If Yes, is the employee or agency a member? Yes _____No ____

Does the nonprofit organization have any contracts with the State?

Yes _____ No ______

Location __________________________________ Date(s) __________

Overnight accommodation required? Yes _______ No _______

Out-of-state travel required? Yes _______No ________

Estimated total costs? $___________

Breakdown of Costs: Transportation $_______ Meals $_____

Accommodations $____ Registration Fees $___

Agency to pay costs? Yes ________ No ________

Sponsor to pay costs? Yes _______ No ________

Employee to pay costs? Yes ________ No ________

Other person or entity to pay costs? Yes _____ No _____ If yes, note name below:

__________________________________________________________

Reason for attendance: _______________________________________

__________________________________________________________

__________________________________________________________

Will sponsor offer an honorarium or fee? Yes _______ No _________

Check: _____ Copy of invitation letter attached.

_____ Copy of agenda or other description of event attached.

____________________________________ _________________

Employee Signature Date

____________________________________ _________________

Supervisor's Signature and Approval Date

NOTE: Any substitutions or changes of circumstances must be reported to your ELO.

*****************************************************

SPACE BELOW FOR ELO USE ONLY

Attendance approved Yes _______ No ______ Note: Acceptance of honoraria or fees is not permitted.

Conditions:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________

Signature ________________________________ Date ____________

Ethics Liaison Officer

_____ Sponsor is an interested party and employee will be accepting event benefits as a speaker, panelist or resource person. A copy of form will be forwarded to the State Ethics Commission pursuant to 19:61-6.4(f).

N.J. Admin. Code § 19:61-6.8

Recodified from 19:61-6.7 and amended by R.1997 d.88, effective 2/18/1997.
See: 28 N.J.R. 4755(b), 29 N.J.R. 593(a).
Added the "Note" relating to substitutions or changes to the request form.
Amended by R.2004 d.390, effective 10/18/2004.
See: 36 N.J.R. 2316(a), 36 N.J.R. 4842(a).
Rewrote the section.
Amended by R.2006 d.292, effective 8/21/2006.
See: 38 N.J.R. 1804(a), 38 N.J.R. 3318(a).
Section was "Sample approval request form". Rewrote the section.
Amended by R.2010 d.283, effective 12/6/2010.
See: 42 N.J.R. 1014(a), 42 N.J.R. 2980(a).
Deleted designation (a); and rewrote the approval form.