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                    "text": "OUTSIDE EMPLOYMENT OR BUSINESS ACTIVITY REQUEST",
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                                    "text": "Kentucky State University"
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                                    "text": "6. Are you now engaged in any outside employment? □Yes □No …"
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                                    "text": "Immediate Supervisor: □ Approval □ Disapproval"
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                                    "text": "Vice President: □ Approval □ Disapproval"
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                                    "text": "General Counsel: □ Approval □ Disapproval"
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                            "text": "Kentucky State University",
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                            "text": "Section 1 - To be completed by employee",
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                            "text": "1. Employee Name (Last, first, middle)",
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                            "text": "3. Date of Hire",
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                            "text": "4. Supervisor Name",
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                            "text": "5. KSU Work Schedule: □F/T □P/T □Intermittent □Temp □ Seasonal□ Other",
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                            "text": "9. Proposed Work Schedule (Days/Hours)",
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                            "text": "10. Proposed Start and Ending Date:",
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                            "text": "11. Describe the Outside Employment or Business Activity (Use Additional Sheets if Necessary)",
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                            "text": "12. I hereby certify that the statements made in this Section are complete and correct to the best of my knowledge.",
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                            "text": "Employee Signature",
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                            "text": "Date",
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                            "text": "Section 2 - Recommendations of Supervisory Officials",
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                            "text": "A. Receipt of Initial Request:\nDate:\nD. In considering this request for outside employment or business activity, I have reviewed the Kentucky State University Employee and/or Faculty Handbooks, Conflict of Interest Policy and the Code of Conduct/Ethics policies and understand the employees' responsibilities and obligations to the University. My recommendation is made in accordance with those provisions.",
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                            "text": "(Date)",
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                            "text": "Vice President: □ Approval □ Disapproval",
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                            "text": "General Counsel: □ Approval □ Disapproval",
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                            "text": "Copies: Official Employee File, Employee, Supervisor",
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                                    "text": "□ Approval □ Disapproval"
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                            "text": "(Signature and Title)\nSection 3 – Approval or Disapproval\nDenials of outside employment or business activity must include a statement of the reasons for disapproval. Review the factors contained in section 2(D) above and attach a complete statement setting forth the rationale for disapproval.",
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                            "text": "Director of Human Resources:",
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                            "text": "(Signature and Title)",
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                            "text": "(Date)",
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                        {
                            "id": "p2.3.7",
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                            "text": "GENERAL\nThis statement is provided pursuant to Privacy Act of 1974, 5 U.S.C. § 552a, for individuals requesting authorization for outside employment and business activities.",
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                            "bbox": {
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                            "text": "PURPOSES AND USES",
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                            "text": "The information you furnish on this form will be used by your supervisory officials to evaluate your request. The information will be used on a “need to know” basis by University officials and when appropriate, may be furnished to other individuals and entities as described in the routine uses for the General Employment and Payroll system of records.",
                            "attrs": {
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                            "id": "p2.3.10",
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                            "bbox": {
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                            "text": "EFFECTS OF NONDISCLOSURE",
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                            "type": "table_cell",
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                            "text": "Providing the requested information is voluntary, however, failure to furnish the information required may result in the disapproval of your request.",
                            "attrs": {
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                                "col": 0,
                                "rowspan": 1,
                                "colspan": 2,
                                "bbox_refit": true
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                            "reading_order": 10
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                        {
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                            "type": "table_cell",
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                            "text": "INSTRUCTIONS FOR COMPLETION",
                            "attrs": {
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                            "text": "Section 1 - Completed by Employee\\nEach item in this section must be completed accurately; failure to do so may result in delay of disapproval of the request. If information regarding any item(s) is: not applicable, not known, or does not apply to this subject request, the appropriate entry must be made and accompanied by an explanation.",
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                            "text": "Section 2 - Completed by Immediate Supervisor, Vice President and the Director of Human Resources.\\nManagement should make a final decision on this request to engage in outside employment or business activity as soon as possible in accordance with University policy, but not later than ten (10) workdays from receipt of the fully completed request.\\nUpon initial receipt of a request, the immediate supervisor must complete item 2A. At the same time, the request should be reviewed for completeness with particular attention given to Section 1, Item 13, which should describe in detail the requested activity. If additional information is necessary the request should be returned to the employee and the employee advised in writing, if necessary, of the additional information required.\\nUpon receipt of a fully completed request, Item 2B, should be completed and the deadline for approval/disapproval, Item 2C, computed (in workdays) and noted. Any reasons for a delay of the process should be documented.\\nThe immediate supervisor and all subsequent reviewers should carefully consider item 2D, complete the appropriate blocks, provide his or her recommendation and attach any remarks, comments or concerns.",
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                    "text": "Management must make a final decision on this request to engage in outside employment or business activity as soon as possible, but not later than ten (10) workdays from receipt of the fully completed request.",
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                    "text": "Following receipt of a fully completed request careful review of all information contained on the request should take place. A complete statement setting forth the rationale for any disapproval must accompany the request when returned to the requesting employee.",
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