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6. Description(s) of Contract(s) or Purchase(s) (Describe the kind of contract involved, and <br /> the effective date and term of the contract or purchase if reasonably determinable. Dates required <br /> if 4(a) is selected above. If"dependent" is involved, provide dependent's name and relationship): <br /> 7. Description of My Financial Interest (Describe in what manner the public servant or <br /> "dependent" expects to derive a profit or financial benefit from, or otherwise has a pecuniary <br /> interest in, the above contract(s) or purchase(s); if reasonably determinable, state the <br /> approximate dollar value of such profit or benefit.): <br /> (Attach extra pages if additional space is needed) <br /> 8. Approval of Appointing Officer or Body (To be completed if the public servant was <br /> appointed by an elected public servant or the board of trustees of a state-supported college or <br /> 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 <br /> the 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 /> 44-1-3; 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 <br /> prior to final action on the contract or purchase.): <br /> Date Submitted Date of Action on Contract or Purchase <br /> 23 <br />