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N ACT SECTION 2-11-2E(3) NMSA 1978 DESIGNATION FORM A As an elected or appointed public officer of the state or its political subdivision, I hereby designate the following employees to appear before legislative committees or in rule making proceeding only to explain the effect of legislation or a rule on his agency or political subdivision. NAME OF STAFF MEMBER Signature of Official Making Designation: State Agency: Address: TITLE OF MEMBER.

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