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1. SUBSCRIBER(AGENCY) 2. DEPARTMENT OF PUBLIC SAFETY, <br /> BUREAU OF CRIMINAL APPREHENSION <br /> Subscriber must attach written verification of <br /> authority to sign on behalf of and bind the entity, Name: <br /> such as an opinion�nl of counsel <br /> or resolution. (PRINTED) <br /> Name: Del i i4 V J t0 1 Signed: <br /> (PRINT • <br /> Signed: ( 1,`-� r Title: <br /> (with delegated authority) <br /> Title: M Date: <br /> (with de el gdted authority) <br /> Date: DWrn Wr t, lO2 3. COMMISSIONER OF ADMINISTRATION <br /> delegated to Materials Management Division <br /> �S kit By: <br /> Name: lac <br /> Date: <br /> yNTED) <br /> Signed: _ <br /> 4. COURTS <br /> •� <br /> Authority granted to Bureau of Criminal Apprehension <br /> Title: 1� C%\10 4t Y/— Name: <br /> (with delegated authority) (PRINTED) <br /> Date: Wei V e '7n�( 02J Signed: <br /> Title: <br /> (with authorized authority) <br /> Date: <br /> 10 <br />