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 5

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2.
BUSINESS ENTITY FILINGS AND REGISTRATION
a. FICTITIOUS NAME: (Select appropriate statement and provide supporting documentation as listed.)
The Applicant will be using a fictitious name or doing business as (“d/b/a”)
Provide a copy of the Applicant’s filing with Pennsylvania’s Department of State
pursuant to 54 Pa. C.S. §311, Form PA-953.
or
The Applicant will not be using a fictitious name.
b. BUSINESS ENTITY AND DEPARTMENT OF STATE FILINGS:
(Select appropriate statement and provide supporting documentation. As well, understand that Domestic
means being formed within Pennsylvania and foreign means being formed outside Pennsylvania.)
The Applicant is a sole proprietor.
-
If the Applicant is located outside the Commonwealth, provide proof of compliance with 15 Pa.
C.S. §4124 relating to Department of State filing requirements.
or
The Applicant is a:
domestic general partnership (*)
domestic limited partnership (15 Pa. C.S. §8511)
foreign general or limited partnership (15 Pa. C.S. §4124)
domestic limited liability partnership (15 Pa. C.S. §8201)
foreign limited liability general partnership (15 Pa. C.S. §8211)
foreign limited liability limited partnership (15 Pa. C.S. §8211)
-
Provide proof of compliance with appropriate Department of State filing requirements as indicated
above.
-
Give name, d/b/a, and address of partners. If any partner is not an individual, identify the
business nature of the partner entity and identify its partners or officers.
-
Provide the state in which the business is organized/formed and provide a copy of the Applicant’s
charter documentation.
-
* If a corporate partner in the Applicant’s domestic partnership is not domiciled in Pennsylvania,
attach a copy of the Applicant’s Department of State filing pursuant to 15 Pa. C.S. §4124.
or
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