Application Form For Parties Wishing To Offer, Render, Furnish, Or Supply Electricity Or Electric Generation Services To The Public In The Commonwealth Of Pennsylvania Page 19
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31Appendix B
OPERATIONS AFFIDAVIT
[Commonwealth/State] of _____________________________ :
:
ss.
County of _________________________
:
________________________, Affiant, being duly [sworn/affirmed] according to law,
deposes and says that:
[He/she is the _____________________ (Office of Affiant) of ___________________
(Name of Applicant);]
[That he/she is authorized to and does make this affidavit for said Applicant;]
That ____________________________, the Applicant herein, acknowledges that [Applicant] may have
obligations pursuant to this Application consistent with the Public Utility Code of the Commonwealth of
Pennsylvania, Title 66 of the Pennsylvania Consolidated Statutes; or with other applicable statutes or
regulations including Emergency Orders which may be issued verbally or in writing during any emergency
situations that may unexpectedly develop from time to time in the course of doing business in Pennsylvania.
That ______________________, the Applicant herein, asserts that [he/she/it] possesses the requisite
technical, managerial, and financial fitness to render electric service within the Commonwealth of
Pennsylvania and that the Applicant will abide by all applicable federal and state laws and regulations and by
the decisions of the Pennsylvania Public Utility Commission.
That __________________, the Applicant herein, certifies to the Commission that it is subject to , will pay,
and in the past has paid, the full amount of taxes imposed by Articles II and XI of the Act of March 4, 1971
(P.L. 6, No. 2 ), known as the Tax Reform Act of 1971 and any tax imposed by Chapter 28 of Title 66. The
Applicant acknowledges that failure to pay such taxes or otherwise comply with the taxation requirements of
Chapter 28, shall be cause for the Commission to revoke the license of the Applicant. The Applicant
acknowledges that it shall report to the Commission its jurisdictional Gross Receipts and power sales for
ultimate consumption, for the previous year or as otherwise required by the Commission. The Applicant also
acknowledges that it is subject to 66 Pa. C.S. §506 (relating to the inspection of facilities and records).
As provided by 66 Pa. C.S. §2810 (C)(6)(iv), Applicant, by filing of this application waives confidentiality with
respect to its state tax information in the possession of the Department of Revenue, regardless of the source
of the information, and shall consent to the Department of Revenue providing that information to the
Pennsylvania Public Utility Commission.
16
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