In an Aggregate Principal Amount Not to Exceed $______

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INDIANA FINANCE AUTHORITY [Educational Facilities] [Health Facilities] [Exempt Facilities] REVENUE BONDS, SERIES 20__

(______PROJECT)

IN AN AGGREGATE PRINCIPAL AMOUNT NOT TO EXCEED $______

APPROVAL OF APPLICABLE ELECTED REPRESENTATIVE

REGARDING PUBLIC APPROVAL FOR THE ISSUANCE OF [Educational Facilities] [Health Facilities] [Exempt Facilities]

REVENUE BONDS OF THE INDIANA FINANCE AUTHORITY

The undersigned is the Treasurer of the State of Indiana and by designation of the Governor of Indiana dated January 11, 2017, is the applicable elected representative of the State of Indiana with reference to the issuance of the Indiana Finance Authority [Educational Facilities] [Health Facilities] [Exempt Facilities] Revenue Bonds, Series 20__ (______Project) (the “Bonds”).

The Indiana Finance Authority (the “Authority”) proposes to issue the Bonds in one or more series in an aggregate principal amount not to exceed _____ Dollars ($______), the proceeds of which will be loaned to ______(the “Borrower”), to be used to: (i) [Insert project description] (the “Project”).

The Project to be financed with the proceeds of the Bonds is located at ______and shall be owned and operated by the Borrower.

A notice of public hearing regarding the Bonds was published in the newspapers and on the dates listed on Exhibit A attached hereto. The notice was designed to apprise the residents of the State of Indiana of the proposed issuance of the Bonds.

On ______, 20__, at 10:00 a.m. a public hearing (the “Hearing”) was held at the office of the Authority, One North Capitol Avenue, Suite 900, Indianapolis, Indiana before the Public Hearing Officer of the Authority with regard to the issuance of the Bonds. The Hearing was conducted in a manner that provided a reasonable opportunity for persons with differing views to be heard on the issuance and financing of the Bonds and the location and nature of the Project to be heard.

The undersigned hereby approves the issuance of the Bonds for the purpose of financing, refinancing or reimbursing the Project for the Borrower. This approval is intended to comply with the provisions of Section 147(f) of the Internal Revenue Code of 1986, as amended.

______

Kelly Mitchell,

Treasurer of the State of Indiana

EXHIBIT A

NOTICES OF THE PUBLIC HEARING

______, 20__ Public Hearing

Newspaper Date of Publication

ART/552861v1

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