Montclair State University

Annual College/University Disclosure Forms Instructions

Under State Ethics Commission regulations (N.J.A.C. 19:61-6.10 (b)) issued on November 19, 2007, all State college/university employees serving in a scholarly capacity are required to disclose annually to their department heads information on travel, subsistence, entertainment expenses, honoraria, academic prizes, or other things of value received in the prior calendar year for activities performed in a scholarly capacity. In addition to reporting the event benefits and other payments, employees are also required to list and reveal the source of any compensation received (other than college/university salary) while acting in a scholarly capacity.

Note: This disclosure requirement does not relieve State college/university employees from their reporting responsibilities under other ethics laws or Executive Orders for activities not performed in a scholarly capacity.


ITEMS TO COMPLETE

Date of Statement: Please use the date the statement is submitted.

For Calendar Year: Enter the year that just ended.

First and Last Names: Enter your legal name.

Institution: Enter the name of the State college/university at which you are employed and acting in a scholarly capacity.

Department and Position: Enter the name of the academic department at which you are employed and your official work title (e.g., Professor, Associate Professor, Researcher).

Daytime Phone Number: Enter the office or cell phone number at which you can be reached during normal business hours.

E-mail Address: Enter either your work or personal e-mail address.

Type of Benefit and Amount of Benefit: List and describe each benefit you received during the reporting period while acting in a scholarly capacity.

Acting in a scholarly capacity (performing pedagogical, academic, artistic, educational, or scholarly activities for your college/university) includes your attendance, participation in, or making presentations at events such as colloquia, seminars, conferences, or other scholarly gatherings. You must list and describe the type, amount, and source of benefits you received. The following are the benefits that you are required to report on the form:

1. Reasonable travel expenses (such as airline or train tickets) provided by the sponsor or another party connected to the event you are attending while acting in a scholarly capacity.

2. Reasonable subsistence expenses (such as a hotel and meal costs) provided by the sponsor or another party connected to the event you are attending while acting in a scholarly capacity.

3. Allowable entertainment expenses (such as incidental music and other ancillary entertainment) received at an event function attended while acting in a scholarly capacity. The entertainment expenses must be considered part of the event that you are attending while acting in a scholarly capacity (e.g., a gala during a conference). It is not permissible to allow an event sponsor or another person associated with the event you are attending in a scholarly capacity to pay for the costs of ancillary personal recreation (e.g., golf games, boat rides) or the costs of attending a sporting or other entertainment activities (e.g., football games, concerts).

4. Honoraria, academic prizes, or other things of value received while acting in a scholarly capacity as a payment for sharing your intellectual property orally or in writing.

Listing of all compensation and sources of compensation: In addition to reporting the event benefits and other payments noted above (a–d), you are also required to list and reveal the source of any compensation you received (other than your college/university salary) while acting in a scholarly capacity. Examples include: acting in an editorial capacity for a journal or other publication; reviewing journal or book manuscripts, grants, or contract proposals; participating in accreditation or other peer review activities; receiving royalties for publications or any other form of secondary employment in which you act in a scholarly capacity.

Authored and assigned course educational materials; royalties: Indicate whether you have assigned educational materials (e.g., textbooks, monographs) you have authored in a course you are teaching and whether you are expected to receive royalties from the educational materials used in that course.
 

Questions regarding the Scholarly Capacity Disclosure Form should be directed to your college/university ethics liaison officer, who will be working closely with the State Ethics Commission on implementing this new requirement.