designates the following expert as a National Public Weather Services Focal Point

* 4. Family name / Surname

* 5. First name / Given name(s)

* 6. Organization

* 7. Mailing address

* 8. Position

* 9. Responsibility

* 10. Telephone

* 11. Mobile

* 12. Email

* 13. Fax

* 14. Date of birth

Date
/
/

* 15. Endorsement from the Permanent Representative (PR)
(adding the name of the PR below is recognized as official signature so this should be done with the PR's approval):

T