
Responsible Official/Duly Authorized Representative Identification Form Submit this form to Northwest Clean Air Agency to identify the Responsible Official and/or the Duly Authorized Representative in accordance with Washington Administrative Code WAC 173-401-200-and 520. SECTION B - Partnership or Sole Proprietorship am a general partner in a partnership. am the owner of this sole proprietorship. SECTION C - Municipality state federal or other public agency am a principal executive officer or ranking elected official. My office/title is My agency is A principal executive officer of a federal agency includes the chief executive office having responsibility for the overall operations of a principal geographic unit of the agency e.g. a regional administrator of EPA SECTION D - Signatures Date Duly Authorized Representative Note Completion of this form applies to certification of all AOP reports. Complete one of the following Section A B or C. Sign form in section D. SECTION A - Corporati....
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How to fill out the Duly Authorized Representative Form online
Completing the Duly Authorized Representative Form is an essential process for identifying the responsible official and duly authorized representative for your facility. This guide provides step-by-step instructions to ensure accurate and efficient completion of the form online.
Follow the steps to complete the Duly Authorized Representative Form online.
- Press the ‘Get Form’ button to access the Duly Authorized Representative Form and open it for online editing.
- In the form, begin by entering the facility name in the designated field. This should match the official name of the facility for which the form is being submitted.
- Next, fill in the Air Operating Permit (AOP) number if applicable. This number is vital for identifying the specific permit associated with the facility.
- If you are submitting this form as notice of an administrative amendment to the existing facility's AOP, check the appropriate box.
- Choose one of the sections to complete: Section A for Corporations, Section B for Partnerships or Sole Proprietorships, or Section C for Municipalities or Public Agencies. Follow the relevant instructions for your choice.
- Complete Section A by certifying that you are qualified as the responsible official. Provide your title and indicate if you are an officer or someone who performs policy functions. Designate a duly authorized representative by entering their name and business title.
- In Section B, certify your status as a general partner or the sole proprietor, including your name and confirming your qualifications.
- For Section C, identify your title and agency as a principal executive officer or ranking elected official, ensuring clarity of your role.
- After filling out the appropriate sections, proceed to Section D to provide signatures for both the responsible official and the duly authorized representative, along with the date.
- Once all sections are completed, save your changes. You can also download, print, or share the completed form as needed.
Encourage completing the Duly Authorized Representative Form online to facilitate efficient processing with the Northwest Clean Air Agency.
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Get answers to your most pressing questions about US Legal Forms API.
What does authorized representative mean?
Someone who you choose to act on your behalf with the Marketplace, like a family member or other trusted person. Some authorized representatives may have legal authority to act on your behalf.
What is an example of a duly authorized officer?
Duly Authorized Officer means the President, Chief Executive Officer, the Chief Financial Officer, any Vice-President, the Treasurer (if at any time applicable), and the Secretary of the Borrower.
What does duly Authorised mean?
duly authorised means authorised in writing by the Board or by some person authorised on that behalf by the Board.
Who is a duly Authorised representative?
More Definitions of Duly authorized representative Duly authorized representative means somebody who speaks, acts or votes on behalf of others.
What is the meaning of Authorised representative?
Authorised representative means a person who is authorised by a person to appear on his behalf.
Who is a duly authorized representative?
Duly authorized representative means a person who has been designated to appear before the DOE or a State Office in connection with a proceeding on behalf of a person interested in or aggrieved by that proceeding.
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