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USDA, Forest Service 0141301413 0596-0217 <br />FS -1 500-8A <br />F. By signature below, each party ceA fles that the individuals listed in this document as <br />representatives of the individual parties are authorized to act in their respective areas for <br />matters related to this agreement. <br />In witness whereof, the parties hereto have executed this Anneal Operating Plan as of the <br />last date written below. <br />ENE DANA, Sheriff <br />.ittltas County Sheriff s office <br />'t� S>/ ?.* ( <br />Date <br />MICHAEL IC ii i.L L R. WILLIAMS, <br />ILLIA S, Forest Supervisor is r <br />ate <br />U.S. Forest Service, Okanogan --Wenatchee National Forest <br />MICHAEL L. LOUDERNffLK, Special Ageint 1 Charge <br />Date <br />U.S. Forest Service, Pacific Northwest Region <br />The authority and format or this agreement (14 -LE --11061 720-011, Mod 3) have been <br />reviewed and ap-proved for signa.tt re. <br />W r � <br />for <br />01/ 13/2017 <br />DE E TE M. SToFLETH <br />Date <br />11S. Forest Service Grants Management Specialist <br />................ _ Burden Statement <br />According to the Paperwork Deduction Act of 1995, an agency may not conduct or sponsor, and a peTson is not required to respond to a coll:ecdon of information <br />Unless it displays a valid 0M8 control number. The valid OMB control € umber for this information collection is 0596-0217. The tittle required to complete this <br />information collection is estimated to average 3 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and <br />maintaining the data needed, and completing and reviewing the collection of information. <br />The U.S. Department of Agriculture (USDA) prohibits discriminabon in all its programs and acUvi as on the basis of race, color, nakfonal aright, age, disability, and <br />where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, poliiioat beliefs, reprisal, or because all or <br />part of an individual's income is delved from any public assistance. (Not all prohibited bases apply to all programs.) Persons with disabilities who require <br />alternative means for communication of program information (Braille, large pj1nt, audiotape, etc.) should contact USDA's TARGET Center at 202-720-2600 (voice <br />and TDD). <br />To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, DC 20250-9410 or call toll f€ee <br />(866) 632-9992 (voice). TDD users can contact USDA through local relay or the Federal relay at (000) 877-8339 DD) or (366) 377-8642 (relay voice), USDA <br />is an equal oppWun4 provider and employer. <br />Page 6 of 6 <br />