State Programs - Legal Certification form

State: _______
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STATE LE
EGAL OFFICER’’S CERT
TIFICATIO
ON OF

AUTHORIZED CERTIFYING OFFICIA
AL

I he
ereby cerrtify that in
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Nam
me of State
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Nam
me of State Agen
ncy
he officia
al State Agency with autho
ority unde
er State la
aw to devvelop, su
ubmit, and
is th
adm
minister or supervvise the administra
ation of the State Plan und
der the Library Se
ervices
and
d Techno
ology Act;; that
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Nam
me of Au
uthorized
d Certify
ying Offic
cial
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Title of Authorized Certifyin
ng Officiial
he officerr authorizzed to su
ubmit the State Pla
an, sign all assurances, ce
ertificatio
ons, and
is th
repo
orts and to whom
m the gran
nt award is made for the named Sttate Agen
ncy; that the
State Treasurer or
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Title of Officer othe
er than State Tre
easurer

w to receiive, hold,, and disb
burse Fe
ederal fun
nds unde
er the
hass authoritty under State law
State Plan; and that all provissions con
ntained in
n the Plan are con
nsistent with State
e law.
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Sig
gnature of Attorn
ney Gene
eral or Other Sta
ate Legall Officer
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Prin
nt Name
e and Titlle
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Datte
OMB No
o. 3137-00
071; Expira
ation Date: 9/30/2015
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