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ra <br />Declination Form <br />For The <br />U.S. Department of Homeland Security (DHS) <br />FY2004 State Homeland Security Grant Program (SHSGP) <br />The County of declines to participate in the grant program and <br />elects not to receive grant funds., Please sign this form in the space below if the local <br />government elects to decline the grant fund. I understand the allotted funds will be redistributed <br />to other local governments. <br />Signature of the Chair Printed Name of the Chair Date <br />Of the County Commissioners Of the County Commissioners <br />DHS FY2004 SHSGP Honer B: Subgrant Forms 4 of 7 <br />