Notice Of A Joint Powers Agreement
Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Notice Of A Joint Powers Agreement Form. This is a California form and can be use in Special Filings Secretary Of State.
Loading PDF...
Tags: Notice Of A Joint Powers Agreement, NP SF 404A, California Secretary Of State, Special Filings
FILE NO.____________________________
State of California
Secretary of State
NOTICE OF A JOINT POWERS AGREEMENT
(Government Code section 6503.5)
Instructions:
1.
Complete and mail to: Secretary of State, P.O. Box 942877,
Sacramento, CA 94277-0001.
2.
Include filing fee of $1.00.
3.
Do not include attachments, unless otherwise specified.
4.
A copy of the full text of the joint powers agreement and amendments, if any, must be submitted to the State
Controller’s office. For address information, contact the State Controller’s office at www.sco.ca.gov.
(Office Use Only)
Name of the agency or entity created under the agreement and responsible for the administration of the agreement:
Agency’s or Entity’s Mailing Address:
Title of the agreement:
The public agencies party to the agreement are (if more space is needed, continue on a separate sheet and attach it to
this form):
(1)
(2)
(3)
Effective date of the agreement: _____________________________________________________________________
Provide a condensed statement of the agreement’s purpose or the powers to be exercised:
_________________________________________
Date
RETURN ACKNOWLEDGMENT TO: (Type or Print)
NAME
_________________________________________
Signature
ADDRESS
CITY/STATE/ZIP
_________________________________________________
Typed Name and Title
SEC/STATE NP/SF 404A (REV. 10/2010)
