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SIGNATURE AUTHORIZATION FORM (SAF) <br />WASHINGTON MILITARY DEPARTMENT <br />Camp Murray, Washington 98430-5122 <br />Please read instructions on page 2 before completing this form. <br />NAME OF ORGANIZATION <br />Kittitas County <br />DATE SUBMITTED <br />GRANT PROGRAM - Acronyms Accepted <br />24EMPG <br />AGREEMENT NUMBER(S) <br />E26-254 <br />1. AUTHORIZING AUTHORITY <br />PHYSICAL SIGNATURE <br />E-SIGNATURE <br />PRINT OR <br />TYPE NAME <br />TITLE & TERM OF OFFICE <br />(If applicable) <br />Clay Myers <br />Sheriff/December 2026 <br />2. AUTHORIZED TO SIGN AGREEMENTS / AMENDMENTS <br />PHYSICAL SIGNATURE <br />E-SIGNATURE <br />PRINT OR <br />TYPE NAME <br />TITLE & TERM OF OFFICE <br />(If applicable) <br />Clay Myers <br />Sheriff/December 2026 <br />3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT <br />HYSICAL SIGNATURE <br />E-SIGNATURE <br />PRINT OR <br />TYPE NAME <br />TITLE & TERM OF OFFICE <br />(If applicable) <br />W14ANancy <br />Shaff <br />Chief Administrative Deputy <br />s <br />Darren Higashiyama <br />Chief Deputy <br />SAF Revised 5/8/2024 <br />Page of <br />