<p> E-GRANTS USER INFORMATION New User Re-activation Date: </p><p>Last Name: First Name: </p><p>Company/Agency: </p><p>Position Title: </p><p>Mailing Address: </p><p>City: State: ZIP Code: </p><p>Daytime Phone: Alternate Phone: Fax Number: </p><p>Email Address: ACCESS RIGHTS Indicate level of access rights below:</p><p>View/Print Level </p><p>For individuals who only need to view and print the application</p><p>Create/Edit Level </p><p>For individuals who will be creating and editing the application</p><p> Includes View/Print Level Rights Sign/Submit Level </p><p>This is limited to individuals who have the authority to commit the Sub-applicant for the required funding of 25% local match and submit the application to the state</p><p> Includes View/Print and Create/Edit Level Rights Are you the Primary Point of Contact? Yes No</p><p>The Primary Point of Contact must have Create/Edit Access Level Rights or higher AUTHORIZATION Must be signed by a Judge, Mayor or agency head to designate which individuals are granted access and their level of access rights</p><p>Signature: Date: </p><p>Position Title: This request form must be filled out in its entirety, signed by the designated official, scanned, and emailed to either Eileen Whitaker at [email protected] or Christy King at [email protected]</p><p>Texas Division of Emergency Management Texas PDM – Request for Access Rights to e-Grants System Form # TDEM-16 / Revision 04-24-14</p>