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rR ti <br /> INSTRUCTIONS FOR COMPLETING SIGNATORY FORM AND CERTIFICATION <br /> 1. Indicate name and address of the recipient. <br /> 2. Two authorized signatures shall be required on all Requisition for Funds forms.The Division of Community Assistance <br /> will check the signatures on each requisition form to see that they match the authorized signatures on the Signatory <br /> Form and Certification. Only the signatures of persons shown on the Signatory Forms and Certification will-be <br /> accepted. <br /> 3. To allow for flexibility in making requisition requests, it is recommended that four authorized signatures appear <br /> on the Signatory Form and Certification.Local governments may choose one of two options in completing the Cer- <br /> tification. If the local government.chooses to use the first option, the chief elected official or the chief finance <br /> officer must sign the form as the certifying official. In signing as the certifying official, the chief elected official <br /> or chief finance officer certifies that : 1) the signatures are authentic and 2) that the persons designated as <br /> signatories are authorized to sign requisitions for pay(nent.If the chief elected official or the chief finance officer <br /> is the certifying official, that person may not also be an authtorized signature. <br /> If the community wishes to have both the chief elected official and,the chief finance officer sign requisitions for <br /> payment, the community should select the second option for certification. In this case,the governing board must <br /> pass a resolution authorizing sufficient persons to act as signatories.In addition,an individual who is not designated <br /> as a signatory must certify the authenticity of the authorized signatures. Anyone who knows all of the persons <br /> authorized to sign requisitions may sign as the certifying official.Another local government staff person or member <br /> of the governing body is recommended. <br /> 4. If the recipient wishes to change the persons authorized to sign the requisition for funds form a new Signatory <br /> Form and Certification must be submitted to the Division of Community Assistance. <br /> 5. No erasures or corrections may appear on the Signatory Form and Certification. <br /> r _ - - <br /> r � <br /> Tl - <br /> J <br /> (f <br /> 'fY <br /> r <br /> r <br />