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INTERNAL CONTROL TRAINING CERTIFICATION
FOR ELECTED OFFICIALS,APPOINTEES,AND EMPLOYEES
I, n t R&W)Ak5the duly elected, appointed, or employed
(print name)
n 1n
CCj ff n� for ak,, dCP(jyLmfft[- certify that I
(position or title) (political subdivision)
received the following training concerning internal controls standards and procedures as required
by Ind.Code § 5-11-1-27(g)(2):
Title of Training Time Spent
1YAPmo� Cdn�ro� rn`nS.
Date:
Signature
* This certification may be printed, signed, and retained in paper form or electronically. If
signed electronically,the elected official, appointee, or employee must designate his or her
signature by typing the last four(4) digits of their Social Security number in the signature line.