RUS Form 675 (Rev. 01-97)

CERTIFICATE OF AUTHORITY

This form is used to indicate the company officers and/or manager authorized to sign the certification on RUS Form 481 for telecommunications borrowers or RUS Form 595 for electric borrowers. At the time such authorization is being made a certified copy of the resolution of the board of directors and one copy of RUS Form 675, Certificate of Authority, shall be submitted to RUS

This form must be completed as follows:

Fld Name /
Item No.

Instruction

Borrower's Name

Enter the complete legal name of the company.

Borrower's Address

Enter the company address including the street, city, state, and zip code.

Date

In the first blank enter the month and day, i.e. "January 1." In the following two boxes enter the year, i.e. "03."

RUS Form 481 Checkbox

Check this box if your company is a telecommunications borrower. This signifies that your company has a loan, grant, or loan/grant combination administered by the RUS Telecommunications Program.

RUS Form 595 Checkbox

Check this box if your company is an electric borrower. This signifies that your company has a loan, grant, or loan/grant combination administered by the RUS Electric Program.

Title

Enter the title of the person that is being authorized to sign the RUS Form indicated above.

Name

(Type or Print)

Insert the name of the person that is being authorized to sign the RUS form.

Signature

Have the person being authorized to sign the RUS Form 675, sign on this line.

Borrower's

Name

Enter the organization's name.

Signature of

President

The president of the organization needs to sign on this blank.

Signature of

Secretary

The Secretary of the organization needs to sign on this blank

Date

Enter one digit per box to indicate the date the form is signed,

i.e. 01-01-2003.

A hard copy of this form should be mailed to the appropriate regional office.