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Affidavit <br />Under penalty of perjury, the undersigned officials certify that they have read and understand their obligations under the <br />Equitable Sharing Agreement and that the information submitted in conjunction with this Document is an accurate accounting <br />of funds received and spent by the Agency under the Guide during the reporting period and that the recipient Agency is <br />compliant with the National Code of Professional Conduct for Asset Forfeiture. <br />The undersigned certify that the recipient Agency is compliant with the applicable nondiscrimination requirements of the followinc <br />laws and their implementing regulations: Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq.), Title IX of the <br />Education Amendments of 1972 (20 U.S.C. § 1681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. § 794), and <br />the Age Discrimination Act of 1975 (42 U.S.C. § 6101 et seq.), which prohibit discrimination on the basis of race, color, national <br />origin, disability, or age in any federally assisted program or activity, or on the basis of sex in any federally assisted education <br />program or activity. The Agency agrees that it will comply with all federal statutes and regulations permitting federal investigators <br />access to records and any other sources of information as may be necessary to determine compliance with civil rights and other <br />applicable statutes and regulations. <br />During the past fiscal year: (1) has any court or administrative agency issued any finding, <br />judgment, or determination that the Agency discriminated against any person or group in violation <br />of any of the federal civil rights statutes listed above; or (2) has the Agency entered into any <br />settlement agreement with respect to any complaint filed with a court or administrative agency <br />alleging that the Agency discriminated against any person or group in violation of any of the <br />federal civil rights statutes listed above? <br />❑ Yes ® No <br />Agency Head <br />Name: Dana, Gene <br />Title: Sheriff <br />Email: gene.dana@co.kittitas.wa.us <br />Governing Body Head <br />Name: Jewell, Paul <br />Title: Chairman <br />Email: paul.jewell@co.kittitas.wa.us <br />To the best of my knowledge and belief, the information provided on this form is true and accurate and has been duly reviewed and authorized by the Law <br />Enforcement Agency Head and the Governing Body Head whose names appear above. Their typed names indicate their acceptance of and their agreement to <br />abide by the policies and procedures set forth in the Guide to Equitable Sharing for State and Local Law Enforcement Agencies, this Equitable Sharing <br />Agreement, and any policies or procedures issued by the Department of Justice or the Department of the Treasury related to the Asset Forfeiture or Equitable <br />Sharing Programs. <br />❑ I certify that I am authorized to submit this form on behalf of the Agency Head and the Governing Body Head. <br />Date Printed: 1/4/2017 Page 3 of 3 February 2016 <br />Version 3.2 <br />