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ATTACHMENT D - STATE AGENCY SIGNATURE AUTHORITY FORM <br />AS THE <br />(Secretary/Director / President / Chancellor) <br />OF THE <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 by <br />the federal Department of Homeland Security and sub-granted through the California Emergency <br />Management Agency. <br />(Name or Title of Authorized Agent) <br />, OR <br />(Name or Title of Authorized Agent) OR <br />(Name or Title of Authorized Agent) <br />Signed and approved this <br />day of <br />20 <br />(Signature) <br />FYI 0 California Emergency Management Agency <br />55E-39 <br />Page 24