**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]{.underline} 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.DOC (2/06); 3/7/06; 1:27 pm