Washington Military Department 6/12/2023

INSTRUCTIONS FOR SIGNATURE AUTHORIZATION FORM This form identifies the persons who have the authority to sign contracts, amendments, and requests for reimbursement. It is required for the management of your contract with the Military Department (MD). Please complete all sections. One copy with original signatures is to be sent to MD with the signed contract, and the other should be kept with your copy of the contract. When a request for reimbursement is received, the signature is checked to verify that it matches the signature on file. The payment can be delayed if the request is presented without the proper signature. It is important that the signatures in MD's files are current. Changes in staffing or responsibilities will require a new signature authorization form. 1.Authorizing Authority. Generally, the person(s) signing in this box heads the governing body of the organization, such as the board chair or mayor. In some cases, the chief executive officer may have been delegated this authority. 2.Authorized to Sign Contracts/Contract Amendments. The person(s) with this authority should sign in this space. Usually, it is the county commissioner, mayor, executive director, city clerk, etc. 3.Authorized to Sign Requests for Reimbursement. Often the executive director, city clerk, treasurer, or administrative assistant have this authority. It is advisable to have more than one person authorized to sign reimbursement requests. This will help prevent delays in processing a request if one person is temporarily unavailable. If you have any questions regarding this form or to request new forms, please call your MD Program Manager.