Fillable Authorization of Signatures Form (City of Pasadena, Texas)

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Authorization of Signatures Form (City of Pasadena, Texas)

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Community Development Department Use ONLY:
Reviewed by: ______________________________ Date: ____________
Approved by: ______________________________ Date: ____________
10/2020
Authorization of Signatures Form
Organization Name
Project/Program Name
Period of Performance
_______________________ to _________________________
Grant Type
IDIS No.
Program Year
ORD. No.
THE INDIVIDUALS NAMED BELOW ARE AUTHORIZED TO SIGN REQUEST FOR PAYMENT
FORMS, REQUESTS FOR BUDGET REVISIONS, CLIENT DATA REPORTING FORMS, GRANT
ACCOMPLISHMENT REPORTS AND OTHER GRANT DOCUMENTS (AS APPLICABLE).
TYPED NAME
TITLE
SIGNATURE OF INDIVIDUAL
*Please note person(s) listed above cannot also be the “preparer” of the grant document he/she is authorizing.
I certify that the above listed signatures are the individuals authorized to co-sign request for payment forms,
requests for budget revisions, client data reporting forms, grant accomplishment reports and other grant
documents (as applicable).
__________________________________________________________________________________________
Name and Title Signature Date
Select Program Year
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Authorization of Signatures Form (City of Pasadena, Texas)

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Completed 25 February 2021

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