State Agency Signature Authority Form

Investment and Governance Division, Office of Information Technology Signature Authority Form Instructions

To authorize Release and Permit requests from your Agency, Board, or Commission electronically, Acquisition Management requires the names and holder title being granted authorization authority.

There should be at least 1 (one) Signature Authority representing each State Agency, Board or Commission. The Signature Authority authorizes requests for IT Release and Permits from their particular Agency. This information only applies to requests processed by Acquisition Management.

The attached form includes an area for you to complete your information to revoke and/or add the most recent list of authorized persons and title holder for that.

Please note: Signature Authorities must be submitted to Acquisition Management using this form.

Please return the completed form via mail to: Please return the completed form via mail to:

Bruce Reichenbach Jim Sutton Information Technology Procurement Services Office of Information Technology 4200or Surface Road 30 E. Broad Street, 39th Floor Columbus, OH 43228 Columbus, OH 43266-0409