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V. Required Signatures <br />I certify that the information provided on this form is true and accurate to the best of my knowledge. I understand <br />that prior to any grant award, the applicant must comply with all application and program requirements of the <br />Public Safety Partnership and Community Po~lici~ng Act 1994 and other requirements of Federal ~l/aw. <br />Law Enforcement Executive's Signature: / • ~ Date: `T ~ o j <br />(signature of person named on the front of this form) <br />_ ___ <br />Government Executive's Signature: ~" ~~~ ` Date: <br />` f person named on t e front of this f m) ll ~ ~ <br />School Official's Signature: ~ ~ Date: ~"r~° 7 ~-~ <br />(signature of person named under "Partner Information" as the designated School Representative for thi grant program and the required training <br />VI. Application Submission Instructions <br />Please return one original and two copies of all application materials that are being submitted with this request for <br />funding. This includes the Community Policing Information Worksheet (for first-time COPS applicants), the <br />Budget Information forms, Assurances, Certifications, a written Retention Plan, the Memorandum of <br />Understanding, the COPS in Schools Narrative Information, and any additional information that is required. <br />Completed applications should be sent to: <br />COPS in Schools Control Desk <br />U.S. Department of Justice <br />1100 Vermont Avenue, NW <br />8th floor <br />Washington, DC 20530 <br />[For overnight delivery, please use 20005 as the zip code.] <br />Note: Since an original signature is needed to process all funding requests, faxed copies will NOT be accepted. <br />OMB Approval Number: 1103-0027 <br />COPS in Schoals Applicatron form <br />