DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
SIGNING AUTHORITY FOR CORPORATE AND LLC OFFICIALS
OMB No. 1513-0036 (10/31/2020)
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
DIRECT
ORS TRUSTEES MANAGERS GOVE
RNORS
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
meeting of the board.
SIGNATURE PRINTED NAME
TITLE DATE
CORPORATE/LLC SEAL
NO SEAL
(If no seal, attach a resolution or meeting minutes
that support the authority(ies) identified above.)
INSTRUCTIONS
Prepare and submit in duplicate to the Director, National Revenue Center, Alcohol and Tobacco Tax and Trade Bureau, 550 Main Street, Suite 8002,
Cincinnati, OH 45202. If your premise is located in Puerto Rico, then mail this form to TTB (PRO), 350 Chardon Ave Suite 310, San Juan PR 00918.
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 offic
ials, 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 0.25
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, 1310 G Street, NW, Box 12, Washington, DC 20005. An agency may not conduct or sponsor, and a person is not required to
respond to, a collection of information unless it displays a current, valid OMB control number.
TTB F 5100.1 (08/2018)
