PM-11, Disclosure of Outside Employment

PM-11: Disclosure of Outside Employment

All full-time employees of the LSU System and all Faculty regardless of FTE status, must complete an outside employment disclosure each fiscal year.  The forms must be completed, even if outside employment does not exist.  Please use the electronic disclosure form located here:  PM 11 Form A.   

Please see below for specific details and FAQs. Thank you for your prompt cooperation! 

Electronic Reporting Method:

All employees subject to PM-11 reporting will be notified via email to submit the annual disclosure.  The email will contain a link to the site where the electronic disclosure form is located.  

If you have no outside employment, indicate "no" on the electronic form and press "save & continue." 

If you have outside employment, complete the electronic form, print and sign.  Forward the signed form to your department chair/head/director.  After review, the department chair/head/director should forward the form to the Office of Legal Affairs and Organizational Integrity.  Blanket approvals will not be granted. 

The Office of Legal Affairs and Organizational Integrity will review the submission and monitor the signature process.  Additional information may be requested from the discloser if required by PM-11. 

To review LSUHSC-S Policy on Disclosure of Outside Employment, see Permanent Memorandum 11  PM-11 Policy and the Code of Governmental Ethics   La. R.S. 42:1111-Payment from nonpublic sources,    La. R.S. 42:1112-Transactions,  La. R.S. 42:1113-Contractual Arrangements, and  La. R.S. 42:1115-Gifts. 

Frequently Asked Questions about PM-11: 

1.  Who completes a PM-11 Form A? 
LSUHSC-S Employees, Post-Doctorate Fellows, Classified, Unclassified, Graduate Assistants and Faculty, as well as House Officers,  even if outside employment does not exist.

2. Who does not complete a PM-11 Form A? 
Students, transients and part-time employees. 

3What if I fall under the scope of the policy but don't have outside employment? 
Complete PM-11 Form A by checking "no" to outside employment and submit your disclosure.  No further action is required by you. 


4. What if I fall under the scope of the policy and I have outside employment? 
Complete the PM-11 Form A and  print. Sign and date the printed form and forward to your Department Director/Chair/ Head. Department Directors/Chairs/Heads must review the form, sign and return originals to the Department of Legal Affairs no later than December 13, 2013 for final signatory authority and approval. 

5.  Where can I obtain a PM-11 Form A? 
The form is available in electronic format at PM-11 Form A 


6.  How do I submit the PM-11 Form A? 
Currently the form may be populated in an electronic format (accessed at the above link), which must then be submitted hardcopy to your department head/chair for signatory approval in the event of any disclosure of outside employment. Signed and completed forms are returned to the Department of Legal Affairs and Organizational Integrity via Campus Mail or U.S. Mail. 

7.  What if I have more than one outside employer? 
You must submit a separate form for each outside event. 

8.   When am I required to submit PM-11 forms? 
Annually upon notification via email, you must indicate if you have outside employment.  Also, if you obtain new or additional outside employment subsequent to your annual disclosure, you must submit a new PM-11 Form A for each new outside employment.