Amended items - Laserfiche WebLink

I L' . Affidavit - Existing Participant Under penalty of perjuryf the undersigned officials certify that they have read and understand their obligations under the Equitable Sharing Agreement and that the information submitted in conjunction with this Document is an accurate accounting of funds received and spent by the Agency under the Justice and/or Treasury Guides during the reporting period and that the recipient Agency is in compliance with the National Code of Professional Conduct for Asset Forfeiture. The undersigned certify that the recipient agency is in compliance with the nondiscrimination requirements of the following laws and their Department of Justice implementing regulations: Title VI of the Civil Rights Act of 1964 (42 U.s.c. 9 2000d et seq.), Title IX of the Education Amendments of 1972 (20 u.s.c. 91681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 u.s.c. 9 794), and the Age Discrimination Act of 1975 (42 U.S.c. 9 6101 et seq')f which prohibit discrimination on the basis of racef color, national originf disabilitYf or age in any federally assisted program or activitYf or on the basis of sex in any federally assisted education program or activity. Agency Head Signature, 9a.......LJJ. - y Name: Paul D. Laney ~ Title: Sheriff Governing Body Head Signature: Name: Robyn Sorum Title: Cass County Commission Chair Date: 02/12/2009 Date: 02/17/2009 Final Instructions: Step 1: Click button to save in PDF format for your records Step 2: Click button to save in XML format Step 3: E-mail the XML file as attachment to aca.submit@usdoj.gov Step 4: Fax a signed copy of THIS PAGE ONLY to (202) 616-1344 Note: The Agency will not be in compliance until the e-mail and the fax of this page are received. FOR AGENCY USE ONLY Entered by Entered on II 111111111 111111111 m II I FY End: 12/31/2008 NCIC: ND0090000 Agency:Cass County Sheriff's Office State: ND Contact Richard Majerus Phone:701-241-5813 E-mai I:MajerusR@casscountynd.gov Page 5 of 5 January 2009 Version 1.5