HomeMy WebLinkAboutGrant Authorized Signer Round IVGrant Documents Authorized Signers
Please clearly print or type all sections of this form.
Community/Grantee Name:
Native Village of Cantwell
Regular Election is held: Date:
In the end of January. lu'(°
Authorized Grant Signer(s):
Printed Name
Title
Term
Signature
Veronica Nicholas
President
1 Year
I authorize the above person(s) to sign Grant Documents:
(Highest ranking organization/community/municipal official)
Printed Name
Title
Term
Signature
Veronica Nicholas
President
1 Year
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Grantee Contact Information:
Mailing Address:
P.O. Box 214
Cantwell, AK 99729
Phone Number:
907-768-2591
Fax Number:
907-768-1111
E-mail Address:
hallvc@mtaonline.net
Federal Tax ID #:
92-0046670
Please submit an updated form whenever there is a change to the above information.
Please return the original completed form to:
Alaska Energy Authority
813 W. Northern Lights Blvd.
Anchorage, AK 99503
C:wrnenNative Village of Cantwell Information\Hydro Project\AEA Round 4\Grant_ Authorized_Signers4.doc