Laserfiche WebLink
S|GNATURE AUTHORIZATION FORM (SA <br />WASHI NGTON M ILITARY DEPARTMENT <br />Camp Murray, Washington 98430-5122 <br />Please read instructions on page 2 before completing this form' <br />F) <br />DATE SUBMITTEDNAME OF ORGANIZATION <br />Kittitas County <br />E26-241 <br />NUMBER(S)AGGRANT PROGRAM - AcronYms Accepted <br />25EMPG <br />1. AUTHORIZING AUTHORITY <br />TITLE & TERM OF OFFICEPRINT OR <br />TYPE NAMEE.SIGNATUREPHYSICAL SIGNATURE <br />Sheriff/December 2026Clay Myers <br />2. AUTHORIZED TO SIGN AGREEMENTS / AMENDIVIENTS <br />TITLE & TERM OF OFFICEPRINT OR <br />TYPE NAMEE.SIGNATUREPHYSICAL SIGNATURE <br />Sheriff/December 2026Clay Myers <br />Budg et & Finance DirectorZack DeHaven <br />3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT <br />rf <br />TITLE & TERM OF OFFICE <br />E.SIGNATURE PRINT OR <br />TYPE NAME <br />Chief Administrative DePutYNancy Shaff <br />Chief DeputyDarren Higashiyama <br />SAF Revised 518/2024 <br />Page _ of