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Limited Liability Company Authorization Form For Alabama Underground And Aboveground Storage Tank Trust Fund Charge Application - Alabama Department Of Revenue

TOB: LLC-AUTH1

LABAMA

EPARTMENT OF

EVENUE

9/12

& L

USINESS

ICENSE

IVISION

, S

& L

OBACCO

EVERANCE

ICENSE

ECTION

P.O. Box 327556 • Montgomery, AL 36132-7556 • (334) 353-7827

Limited Liability Company Authorization Form

for

Alabama Underground and Aboveground

Storage Tank Trust Fund Charge Application

I am signing as a member of the LLC for which an application for a cargo tank permit is submitted, I hereby

certify, under penalty of perjury, as follows: (1) I am vested with full authority to execute this Application on

behalf of the LLC; and (2) the Articles of Organization or any operating agreements of the LLC DO NOT pro-

vide that management is vested in a manager or managers.

_________________________________________________________________________, LLC

A Limited Liability Company

By: ___________________________________________________________________________

Its Member

I am signing as manager of the LLC for which an application for a cargo tank permit is submitted, I hereby cer-

tify under penalty of perjury, as follows: (1) I am vested with full authority to execute this Application and/or

Bond on behalf of the LLC; and (2) the Articles of Organization or any operating agreements specifically vest

management authority in me.

_________________________________________________________________________, LLC

A Limited Liability Company

By: ___________________________________________________________________________

Its Manager

STATE OF ______________________________________

COUNTY OF ____________________________________

I, the undersigned, a Notary Public in and for said County, in said State, hereby certify that _______________

_________________________________________ whose name as ________________________________________,

of _____________________________________________, LLC, is signed to the foregoing instrument and who is

known to me, acknowledged before me on this day that, being informed of the contents of said instrument,

(s)he, as such member or manager, and with full authority, executed the same voluntarily on the day the same

bears date for and as the act of said Limited Liability Company.

Given under my hand and seal this _________ day of _________________, _________.

________________________________________________

NOTARY PUBLIC

(Instructions on Back)

Limited Liability Company Authorization Form For Alabama Underground And Aboveground Storage Tank Trust Fund Charge Application - Alabama Department Of Revenue

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