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APPENDIX C- STATE AGENCY FORMS <br />SIGNATURE AUTHORITY <br />AS THE <br />OF THE <br />(Secretary/Director / President / Chancellor) <br />(Name of State Organization) <br />I hereby authorize the following individual(s) to execute for and on behalf of the named state <br />organization, any actions necessary for the purpose of obtaining federal financial assistance provided <br />by the federal Department of Homeland Security and sub-granted through the California Emergency <br />Management Agency. <br />(Name or Title of Authorized Agent) <br />(Name or Title of Authorized Agent) <br />OR <br />(Name or Title of Authorized Agent) <br />Signed and approved this <br />day of <br />OR <br />20 <br />(Signature) <br />FY09 California Emergency Management Agency Page 22