Form Ttb F 5100.1 - Signing Authority For Corporate Officials
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1OMB No. 1513-0036
(06/30/2004)
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
SIGNING AUTHORITY FOR CORPORATE OFFICIALS
INSTRUCTIONS
Prepare and submit to the Director, National Revenue Center, Alcohol and Tobacco Tax and Trade Bureau, in duplicate. Each copy must be signed in ink
by a corporate official and be embossed with the corporate seal. This form may be used to list the corporate officials, or employees (if any) , who are
authorized by the articles of incorporation, the bylaws, or the board of directors in adopted resolutions or motions, to act on behalf of the corporation or to
sign its name. If the authorization to sign is granted by position title, rather than to specific individuals by name, a new authorization will not be needed
each time a change of incumbent occurs. WHERE THE AUTHORIZATION IS NOT GRANTED BY THE ARTICLES OF INCORPORATION, THE BY-
LAWS, OR ACTION BY THE BOARD OF DIRECTORS, TTB F 5000.8, POWER OF ATTORNEY, MUST BE SUBMITTED.
PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with Paperwork Reduction Act of 1995. This information collection is used by TTB to ensure that only duly authorized
individuals are signing documents. This information is voluntary.
The estimated average burden associated with this collection of information is .25 hours per respondent or recordkeeper depending on individual
circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be addressed to Reports
Management Officer, Regulations and Procedures Division, Alcohol and Tobacco Tax and Trade Bureau, Washington, DC 20220.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB
control number.
COMPLETE APPLICABLE INFORMATION
NAME AND COMPLETE ADDRESS OF CORPORATION
NEW APPLICANT
PERMIT HOLDER
PERMIT NO.
DATE MEETING HELD
BOARD MEETING
DIRECTORS
TRUSTEES
MANAGERS
GOVERNORS
THE FOLLOWING CORPORATE OFFICIALS, EMPLOYEES, OR INCUMBENTS OF THE OFFICES LISTED ARE AUTHORIZED TO SIGN, OR TO
APPOINT PERSONS AUTHORIZED TO SIGN, DOCUMENTS ( Specify type of documents) SUBMITTED ON THE CORPORATION'S BEHALF TO THE
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU.
CORPORATE SEAL
I certify that this is true and complete and that the above authorization was granted at the cited
meeting of the board.
SIGNATURE
TITLE
DATE
TTB F 5100.1 (4/2004)
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