Authorized Signature Form_2_ by malj

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									                   Georgia Commission for Service & Volunteerism
                             Authorized Signature Form
                                Drawdown of Funds
                                AmeriCorps Program
Name of Legal Recipient:                  AmeriCorps Program Number:


Program Name
Signatures of Individual(s) Authorized to Approve Periodic Expense Report:

 One Signature Required
 Additional Signature(s) Required
Type Name and Signature:                      Type Name and Signature:



Type Name and Signature:                      Type Name and Signature:



I certify that the signature(s) above are of the individual(s) authorized to request
payment of funds for the grant program noted above:


_________________________________                              ____________________
Signature of Authorizing Official                              Date
(May Not Be a Signatory Listed Above)

								
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