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Form 299 - Application For Transportation And Utility Systems And Facilities On Federal Lands - 2009 Page 3

SUPPLEMENTAL

CHECK APPROPRIATE

NOTE: The responsible agency(ies) will provide instructions

BLOCK

I - PRIVATE CORPORATIONS

ATTACHED

FILED*

Articles of Incorporation

Corporation Bylaws

c. A certification from the State showing the corporation is in good standing and is entitled to operate within the State

d Copy of resolution authorizing filing

e. The name and address of each shareholder owning 3 percent or more of the shares, together with the number and

percentage of any class of voting shares of the entity which such shareholder is authorized to vote and the name and

address of each affiliate of the entity together with, in the case of an affiliate controlled by the entity, the number of

shares and the percentage of any class of voting stock of that affiliate owned, directly or indirectly, by that entity, and

in the case of an affiliate which controls that entity, the number of shares and the percentage of any class of voting

stock of that entity owned, directly or indirectly, by the affiliate.

If application is for an oil or gas pipeline, describe any related right- of-way or temporary use permit applications,

and identify previous applications.

If application is for an oil and gas pipeline, identify all Federal lands by agency impacted by proposal.

II - PUBLIC CORPORATIONS

Copy of law forming corporation

b. Proof of organization

Copy of Bylaws

Copy of resolution authorizing filing

e. If application is for an oil or gas pipeline, provide information required by item "I - f" and "I - g" above.

III - PARTNERSHIP OR OTHER UNINCORPORATED ENTITY

a. Articles of association, if any

If one partner is authorized to sign, resolution authorizing action is

Name and address of each participant, partner, association, or other

d. If application is for an oil or gas pipeline, provide information required by item "I - f" and "I - g" above.

*If the required information is already filed with the agency processing this application and is current, check block entitled "Filed." Provide the file

identification information (e.g., number, date, code, name). If not on file or current, attach the requested information.

STANDARD FORM 299 (REV. 5/2009) PAGE 4

Form 299 - Application For Transportation And Utility Systems And Facilities On Federal Lands - 2009 Page 3

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