RESOLUTION OF THE __Governing Board____ OF THE

_____________Name of agency_____________________________

INITIATING PROCEEDINGS FOR THE ___LAFCo action_________ OF TERRITORY

RESOLUTION NUMBER ______________

This section is optional WHEREAS, the ___Name of agency___ desires to initiate proceedings pursuant to the Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000, commencing with Section 56000 of the California Government Code, for a change of organization that would ___(action)___ territory into/from the __(agency)___; and

WHEREAS, this __(action___ is being proposed upon a Resolution of Application to Initiate Proceedings for annexation filed by the ___Name of agency___ on behalf of the ___(City/District/or Landowner Name___; and

WHEREAS, the boundaries of the proposed area are described in the legal description, and depicted on the corresponding map, Exhibit “A” and Exhibit “B”, respectively, for ___action___, which are incorporated herein by reference; and

WHEREAS, the ___Governing Board_________ of the _____Agency______________ does hereby resolve and order as follow:

SECTION 1

a.	Application and proposal is hereby made to the Sacramento Local Agency Formation Commission for the ___(first action) __________ as described in Exhibit A of this Resolution	____________________, and the __(second action, if any)_____ (inhabited/uninhabited) property as described in Exhibit B from ___(name of another agency being impacted by action, if any)__________.

b.	It is desired that the proposed __(actions)________ provide for and be made subject to the following terms and conditions.

c.	The reasons for this proposal are as follows:

d.	The following are the affected agencies:

1.	Sacramento County

2.	Districts:

e.	Request is hereby respectfully made that proceeding be undertaken by the Sacramento Local Agency Formation Commission for the ____(action)_______ proposed herein.

f.	The clerk of this _(name of agency)__ is hereby instructed to file a copy of this resolution with the Sacramento Local Agency Formation Commission.

SECTION 2

g.	The __(governing board)___ hereby designates __(name of person)___ as the authorized agent to prepare, complete, sign, clarify amend all application materials and answer and resolve any subsequent matters on behalf of the __name of agency___

h.	The __(governing board)___ authorizes the payment of any or all fees associated with this resolution of application and other related matters that may need to be undertaken as a result of this application.

i.	Consent is hereby given to the waiver of conducting authority proceedings.

PASSED AND ADOPTED by the _______ of the ____________________________ this ___ day of _________________ 20__, by the following vote:

Moved by: ________________________________________________

Seconded by :________________________________________________

Ayes ________________________________________________

________________________________________________

Noes: ________________________________________________

Absent: ________________________________________________

Abstain: ________________________________________________

____________________________

Chair of the Board of Directors

CERTIFICATION

I hereby certify that the foregoing is a full, true, and correct copy of a resolution duly and regularly introduced, passed, and adopted by the members of the ________ of the ____________________________ District in the County of Sacramento, on _________________ 20__.

____________________________

Secretary of the Board of Directors

Include a meets and bounds description of the territory and applicable map.

Inhabited if there are 12 or more registered voters residing within the territory; Uninhabited if there are fewer than 12 registered voters.

Insert any terms or conditions you wish to impose as a condition on this reorganization.