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12. Describe problems and the proposed treatment for which cost share assistance is needed <br />13. Original signature of applicant requesting cost share assistance. Applicant must sign and <br />date before the district chair approves the application form. <br />14. Original signature of district chair or designee. The district chair should always be the last <br />person to sign and date the form. <br />15. District chair should check if application was approved or denied by the district board of <br />supervisors. <br />Attachment number 3 <br />F - 8 Page 100 of 199 <br />