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DocuSign Envelope ID: C6C7B351-OCC2-4ADA-92OA-F48362A2DO17 <br />State of Washington <br />Administrative Office of the Courts <br />I, [AOC Comptroller name], have reviewed the Becca reimbursement <br />documents and supporting documentation provided by [county and county <br />designee name] for the time period Fiscal Year [20XX], and do hereby <br />declare that: <br />❑ Documentation is in compliance with Becca cost reimbursement <br />requirements. <br />❑ Documentation is not in compliance with Becca cost reimbursement <br />requirements. The following corrective action must be taken: <br />Summary/detail of corrective action and completion provided here. <br />Signed <br />AOC Comptroller/Designee Date <br />BECCA Guidelines 9/2021 7 IAA23838 <br />