Fillable Ad-30-warrant-officer-authorization Administrative Directive – Warrant Officer Authorization

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Ad-30-warrant-officer-authorization Administrative Directive – Warrant Officer Authorization

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Administrative Directive – AD 30 – 1 ATTACHMENT 2
Warrant officer Authorization
DAT
E:
P
lease type or print your name and extension and sign. Retain a copy for your department’s files. If at any time the primary
officer or an alternate officer changes, please contact our office immediately to update this information.
*B
y signing this form, I have read and understand the warrant officer policy/procedures. I take responsibility for a
ll
w
arrants under my care and I will take necessary measures to secure these items at all times.
Uni
t Code(s): ___________________________________________________
Pr
imary Warrant Officer ___________________________________________________
(Print
Name and Extension #)
(Signature) * _________________________________________________
Alternate Warrant Officer #1 __________________________________________________
(P
rint Name and Extension #)
(P
rint N
ame and Extension #)
(Signature) * _________________________________________________
Al
ter
na
te Warrant Officer #2 __________________________________________________
(Signature) * _________________________________________________
Alternative Warrant Officer #3 __________________________________________________
(Print name and Extension #)
(Print name and Extension #)
(Signature) * _________________________________________________
Alternative Warrant Officer #4 __________________________________________________
(Signature) * _________________________________________________
One University Drive, Camarillo, California 93012-8599 Tel: (805) 437-8810 Fax: (805) 437-8900 www.csuci.edu
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Ad-30-warrant-officer-authorization Administrative Directive Warrant Officer Authorization

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Completed 14 March 2020

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