This government document is issued by Controller, Office of the State for use in North Carolina
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https://www.google.com/url?client=internal-element-cse&cx=011942283435604047485:wxgyq9wheas&q=https://www.osc.nc.gov/documents/ncas-forms/agency-security-administrator-authorization-form-01-28-2020/open&sa=U&ved=2ahUKEwi0qauHypGGAxW0hP0HHeUWCL04KBAWegQIABAB&usg=AOvVaw3urOVAM1OBECyVqxBUsMzT&arm=e