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DESIGNATIQN OF APPLrCANT'S AGENT <br />RESOLUTION <br />BE TT RE50LVED BY <br />(Governing Bndy) <br />OF <br />(PuGLic Entity) <br />THAT , <br />(Name oflncum6ent) (Official Position) <br />OR <br />Governor's Authorized Representative, <br />z <br />is hereby authorized to execute for and in behalf of <br />a public entity established under the laws of the State of <br />,this application and to file it in the appropriate State office for the <br />purpose of obtaining certain Federal financial assistance under the Disaster Relief Act (Public Law 288, 93rd <br />Congress) or otherwise available from the President's Disaster Relief Fund. <br />THAT , a public entity established under the laws of the <br />State of _ ,hereby authorizes its agent to provide to the State <br />and to the Federal Emergency Management Agency (FEMA) for all matters pertaining to such Federal disaster <br />assistance the assurances and agreements printed an the reverse side hereof. <br />Passed and approved this day of „ . 19 <br />(Name and Title) <br />(Name and Title) <br />(Name and Title) <br />CERTIFICATION <br />I, ,duly appointed and of <br />(Title) <br />do hereby certify that the above is a true and correct copy of a <br />resolution passed and approved by the <br />on the <br />Date: <br />(Governing Body) <br />of <br />(Public Entity) <br />day of X 9 <br />(Qfr=tcial Position) (signature) <br />* Name of incumbent need not be provided in those cases where the governing body of the public entity desires to <br />authorize any incumbent of the designated ofFcial position to represent it. <br />Rev, (1Plyy <br />