Form Ttb F 5100.1 - Signing Authority For Corporate And Llc Officials

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OMB No. 1513-0036 (11/30/2010)

DEPARTMENT OF THE TREASURY

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

SIGNING AUTHORITY FOR CORPORATE AND LLC OFFICIALS

NAME AND COMPLETE ADDRESS OF CORPORATION OR LLC

COMPLETE APPLICABLE INFORMATION

CHECK IF YOU ARE A NEW APPLICANT

REGISTRY/PERMIT NO.

BOARD MEETING

DATE OF MEETING

DIRECTORS

TRUSTEES

MANAGERS

GOVERNORS

THE FOLLOWING CORPORATE/LLC OFFICIALS, EMPLOYEES, OR INCUMBENTS OF THE OFFICES LISTED ARE AUTHORIZED TO SIGN, OR

TO APPOINT PERSONS AUTHORIZED TO SIGN, ALL DOCUMENTS UNLESS OTHERWISE SPECIFIED, SUBMITTED ON THE CORPORATION/

LLC'S BEHALF TO THE ALCOHOL AND TOBACCO TAX AND TRADE BUREAU. OUTSIDE CONSULTANTS MAY NOT APPOINT OTHERS TO

SIGN ON THE CORPORATION/LLC'S BEHALF.

I certify that this is true and complete and that the above authorization was granted at the cited

CORPORATE/LLC SEAL

meeting of the board.

SIGNATURE

PRINTED NAME

TITLE

DATE

NO SEAL

(If no seal, attach a resolution or meeting minutes

that support the authority(ies) identified above.)

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/LLC official and be embossed with the corporate/LLC seal (if any). This form may be used to list the corporate/LLC 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. However, if you list an individual's name along with a title/position, the

authority is limited to the period of time that the specific individual holds the specific title/position. If an individual or incumbent's authority is restricted to

a certain area of expertise or specific documents, identify the limitation next to the designation. WHERE THE AUTHORIZATION IS NOT GRANTED BY

THE ARTICLES OF INCORPORATION OR ORGANIZATION, THE BY-LAWS, OR ACTION BY THE BOARD OF DIRECTORS OR MANAGING

MEMBERS, TTB F 5000.8, POWER OF ATTORNEY, MUST BE SUBMITTED.

PAPERWORK REDUCTION ACT NOTICE

This request is in accordance with the 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 sug-

gestions for reducing this burden should be addressed to the Reports Management Officer, Regulations and Rulings 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 infor-

mation unless it displays a current, valid OMB control number.

TTB F 5100.1 (12/2007)