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AUTHORIZA_TJON <br />Acceptance of this application may be subject to subsequent compliance reviews,including a review <br />of the latest audit of financial statement.Preparation of an application does not guarantee that <br />applicants will receive funds.By signing this grant application form the undersigned certifies that all <br />information is accurate to the best of his/her knowledge. <br />08/16/2017 <br />Signature of Authorized Representative Date <br />3