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AS THE <br />OF THE <br />Attachment D —State Agency Signature Authority Form 12014 <br />(Secretary/Director/President/Chancellor) <br />(Name of the 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 Governor's Office <br />of Emergency Services. <br />,OR <br />M <br />Signed and approved this day of 20 <br />(Signature) <br />55B -35 <br />