Purpose of Authorization: To permit an employee who has an appearance of a conflict of interest to participate in an official matter despite that appearance, as defined in 5 CFR 2635.502. Employees whose situation meets the definitions may not participate in the affected official matter until this authorization is approved. Deputy Ethics Counselors are not required to approve every request, and will make a determination based on the facts presented here.

Instructions: Use the required standard language as written, and insert an appropriate justification as directed in the [bracketed italicized text]. Delete all instructions and the note above; ensure that memo is formatted correctly. The authorization may also be requested by an Ethics Specialist or a supervisor on behalf of the employee. In this case, change the pronouns to third person. Print on letterhead.

[Date]

TO:	Deputy Ethics Counselor, [IC]

FROM:	[Employee's name and title]

SUBJECT:	Authorization to Participate Under 5 CFR 2635 Section 502

I request authorization to participate in an official duty matter notwithstanding the appearance of a conflict of interest provisions set forth in 5 CFR § 2635.502. Section 2635.502 (a) states, in part:

Where an employee knows that a particular matter involving specific parties is likely to have a direct and predictable effect on the financial interest of a member of his/her household, or knows that a person with whom he has a covered relationship is or represents a party to such a matter, and where the employee determines that the circumstances would cause a reasonable person with knowledge of the relevant facts to question his/her impartiality in the matter, the employee should not participate in the matter until he has informed the agency designee of the appearance problem and received authorization from the agency designee . . .

Authorization under section 2635.502(d) may be granted by the IC Deputy Ethics Counselor when

. . an employee's participation in a particular matter involving specific parties would not violate 18 U.S.C. § 208 (a), but would raise a question in the mind of a reasonable person about his/her impartiality,

but,

the interest of the Government in the employee's participation outweighs the concern that a reasonable person may question the integrity of the agency's programs and operations.

[ Insert here the facts that raise an appearance of a conflict of interest. For example, I am an employee of XX Laboratory in the National Cancer Institute which is negotiating a collaborative research and development agreement (CRADA) with Bristol Myers Squibb (BMS). My brother, a relative with whom I have a close personal relationship, is a senior vice-president at BMS. While I am a scientist and will work on the CRADA, I will have no role in negotiating the CRADA nor will I have any oversight responsibilities over Bristol Myers' collaboration with this lab. In addition, I have been assured by my brother that neither his position nor possibility of a bonus are dependent on BMS collaborating on this project. ]

For these reasons, I believe authorization to continue my official duties on the CRADA despite the appearance of conflict of interest is appropriate.

DECISION:

Authorization to participate granted based on my determination, made in accordance with section 2635.502(d), that "the need for the individual's services outweighs the concern that a reasonable person may question the integrity of the agency's programs and operations."

Authorization to participate denied.

Deputy Ethics Counselor	Date

Confirmed:	Use this section only for requests from someone on behalf of the employee.

Employee	Date

NEO: AUTH-502.WPD (2/06); 3/7/06; 1:27 pm