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f�4_. <br />=l <br />NATIONAL LEAGUE OF CITIES CREDENTIALS FORM <br />2004 CONGRESS OF CITIES • INDIANAPOLIS, INDIANA <br />teach direct member city of NLC is entitled to cast from one to 20 votes, based upon the city's population per the 2000 census, through <br />its designated voting delegate at the Annual Business Meeting. Please indicate below your city and state, voting delegate and/or <br />alternate(s), and sign and date the credentials form. Mail the form to NLC in the enclosed pre -addressed return envelope. <br />The official voting delegate and/or alternate(s) for the cityltown of are: <br />(please type or print the name of yourcity/town and state) <br />VOTING DELEGATE: <br />FOR OFFICE USE ONLY <br />• NAME (DO NOT WRITE /N THIS SPACE) <br />Voting card issued to: <br />TITLE <br />ALTERNATE VOTING DELEGATE(S): <br />2. <br />NAME <br />3. <br />NAME <br />Signature (city representative) <br />TITLE <br />TITLE <br />Date: <br />(Signature) <br />1. 2. 3. <br />For Office Use. Only (Do Not Write in this Space) <br />City Code: _ Return to: Chair, Credentials Committee <br />National League of Cities <br />Vote.(s): 1301 Pennsylvania Ave., N.W., Suite 550 <br />Washington, D.C. 20004: <br />0 <br />no 4CIf Do 4ckk eri <br />-�eyr, Vl D ConiEMgel/s <br />• <br />s <br />