FY17 RCDG Third-Party Cash Match Verification Template.docx

RCDG

Verification of Third-Party CASH Matching Funds

For purposes of carrying out the Work Plan and Budget Activities identified in the (Center’s) FY 2017 Rural Cooperative Development Grant (RCDG) Program application, and as an Authorized Representative of the third-party organization identified below, I verify and confirm the following information:

(month/day/year) Source

|_| Our governing body (i.e., Board of Directors or Tribal Council) has formally Resolved / Confirmed the Cash Matching contribution amount for RCDG purposes on .

|_| I/We do not need a Resolution because it is not required by our governing body for us to authorize the Cash Matching contribution amount described above.

I/We understand the Cash Matching contribution amount described above is to be used for grant eligible Center expenditures and that I/we cannot limit how or where the Center uses these funds. In addition, I/we understand the Cash Matching contribution amount described above cannot be used to provide services which directly benefit me/us.

Print Name of Authorized Representative:

Signature of Authorized Representative: _____________________________________ Date:

Title of Authorized Representative:

USDA is an equal opportunity provider, employer, and lender.

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