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7. Description of My Financial Interest (Describe in what manner the public servant or "depen- <br />dent" expects to derive a profit or financial benefit from, or otherwise has a pecuniary interest In, <br />the above contract(s) or purchase(s), if reasonably determinable, state the approximate dollar <br />value of such profit or benefit.): <br />(Attach extra pages if additional space is needed.) <br />i3. Approval of Appointing Officer or Body (To be completed if the public servant was appointed by <br />an elected public servant or the board of trustees of a state -supported college or university.): <br />i (We) being the of <br />(Title of Officer or Name of Governing Body) <br />and having the power to appoint <br />(Name of Governmental Entity) <br />the above named public servant to the public position to which he or she holds, hereby approve the <br />participation to the appointed disclosing public servant In the above described contract(s) or <br />purchase(s) in which said public servant has a conflict of interest as defined in Indiana Code 35- <br />44.1-1-4; however, this approval does not waive any objection to any conflict prohibited by statute, <br />rule, or regulation and is not to be construed as a consent to any illegal act. <br />Elected Official Office <br />9. Effective Dates (Conflict of interest statements must be submitted to the governmental entity prior <br />to final action on the contract orpurchose.): <br />Date Submitted (month, day, year) Date of Action on Contract or Purchase (month, day, year] <br />Page 2 of 3 <br />