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SUPPLEMENTAL <br />NOTE: 7Te responsible agency(!es) will provide addltlonal InsttucLLons. CHECK APPROPRIATE <br /> BLOCK <br />I -PRIVATE CORPORATIONS A77ACN8D rlt,gD• <br />s. rticlea of Incorporation ^ ^ <br />b. Corporation BYlaws ^ ^ <br />A Certification from the State showing the corporation is 10 good atasding and Is entitled to operate w1Nln the <br />c' S ^ ^ <br />4te. <br />d. Copy of resolution authorizing (Uing ^ ^ <br />e. The name and address of each shareholder owning 3 percent or more of lha .hare., together with the amber <br />and percentage of any class of voting share. of Ne entity which ouch shareholMr fa agthorlsad to vote and <br />the name sad address of each dfillste of the entity togsffiar with, b the ease at an dflUate eontrollad by the ^ ^ <br />entity, the Dumber of .hares and the percentage of any tl^o of voting stack e! that aiflLala owned, dlrecLLy <br />or indirectly, by that entity, and in the use of an at[lllate which controls that .rarity, the number of .bans <br />and the percentage of .ray class o[ toting stork o[ that entity owned, directly or lndlrottly, by the sfNfata. <br />f. If application is for an oil or ga^ pipeline, describe any relslad rigbtof-way or temporary ass permit appli- ^ ^ <br />cWoas, snd identify previous applications. <br />H• If application is for an oil and gas pipeline, idenllfq all Federal lands by agency Impacted by proposal. ^ ^ <br />II -PUBLIC CORPORATIONS <br />a. CODY of law forming corporation ^ 0 <br />b. Proof o[ organization ^ ^X <br />c. CoDY of Bylaws ^ ^X <br />d. Copy of resolution authorizing (iirng ^ <br />r if application is for an oil or gas pipeline, provide lnformalion required <br />Item "1-f" snd "1-g" above. ^ ^ N/ <br />IO - PART NE RSNIP OR OTHER UNIHCOR PORATED ENTITY <br />•. Article. of association, it any ^ ^ <br />b. If one partner is authorized to sign, resolution authorising action la ^ ^ <br />c. Name and address of each participant, partner, assoclatloD, or other ^ ^ <br />d. If application is for an oil or gas pipeline, provide information required <br />by Item "I-f" and "1-g" above. ^ ^ <br />• If the required Infonaallon 1^ already filed with the agency proesaslag this appLtatloo and is cturont, shack block entitled "Filed." <br />provide the file Identi[lcsllon loformatlon (s. g., number, date, cods, Haws). U nM oo ilia or comet, .Hach the raqueated taformsUoo. <br />NOTICE <br />The Privacy Aet of 1974 prov ide^ that you be furnished the <br />following information in connection with information required by <br />this apDliution for an ^ulhorization. <br />EFFECT OF NOT PROVIDING INFORMATION: Diaclosurc of the <br />irdormation is voluntary. u ail the information is not provided, the <br />applit .lion may be rejected. <br />AUTHORITY: 16 U.S.C. 310; 5 U.S.C. 301. <br />PRINCIPLE PURPOSE. The iNormation is to be used to protest <br />the application. <br />~INE USES: (1) The processing d the applicant'. request <br />authorizat~on. (Z) Documentation for publlt information. <br />ransfer to appropriate Federal gent tea when concumnce <br />rs required prior to granting • right In public lands or rosourees. <br />(4)(5) Infoemallon from the record and/or the rec std will be trans- <br />ferred to appropriate Federal, State, local or foreign .gentles, <br />wMn rclevaM to clvii, criminal or regulatory Invastlgallons or <br />prosesM ions. <br />DATA COLLECTION STATEMENT <br />The Federal ageales collect This Information from applicants <br />rcqueatlq rlghtof-way, perml[, license, lease, or tertific .lion for <br />i eha use of Fadaral lands. <br />The Federal ageale^ use t61s information to evduate the sp- <br />plluM's proposal. <br />The publlt Is obligated to respond to this information request it <br />they wish to obtain perminlon to use Federal Lnda. <br />