Authority: IC 8-2.1-18-6
Affected: IC 8-2.1-18
Sec. 22.
POWERS OF ATTORNEY.
POWER OF ATTORNEY
P.S.C.I. M1 No. ________
Cancels P.S.C.I. M1 No. ________
_________________________________
(Name of Carrier)
_________________________________
(Post Office Address)
____________ , 19 _____
Know all men by this instrument:
That, on the _____ day of _____ , 19 _____ , (see Note 1, paragraph (e)) carrier of property by motor vehicle does (do) hereby make and appoint _____ attorney and agent to publish and file for such carrier freight tariffs and supplements thereto, as permitted or required of common carriers of property by motor vehicle under authority of the Motor Carrier Act, and the regulations of the Public Service Commission of Indiana issued pursuant thereto, and does (do) hereby ratify and confirm all that said attorney and agent may lawfully do by virtue of the authority herein granted and does (do) hereby assume full responsibility for the acts and failure to act of said attorney and agent.
___________________________
(Name of Carrier)
By ___________________________
Attest (If a Corporation):
_____________________________________________ , Secretary.
Duplicate mailed to __________________________________________ , Agent.
_______________________________________________
_______________________________________________
POWER OF ATTORNEY
P.S.C.I. M2 No. ________
Cancels P.S.C.I. M2 No. ________
________________________________
(Name of Carrier)
________________________________
(Post Office Address)
____________ , 197 _____
Know all men by this instrument:
That, on the _____ day of _____ , 19 _____ ,
(See Note 1) a common carrier of property by motor vehicle does (do) hereby make and appoint
(Name of principal agent) attorney and agent to publish and file for such carrier freight tariffs and supplements thereto, as permitted or required of common carriers of property by motor vehicle under authority of the Motor Carrier Act and the regulations of the Public Service Commission of Indiana issued pursuant thereto, and does (do) hereby ratify and confirm all that said attorney and agent may lawfully do by virtue of the authority herein granted and does (do) hereby assume full responsibility for the acts and failures to act of said attorney and agent. And, further, that does
(See Note 1) (do) hereby make and appoint alternate attorney and agent to do and
(Name of Alternate Agent) perform the same acts and exercise the same authority herein granted to in the
(Name of principal agent) event and only in the event of death or disability of
(Name of principal agent)
________________________
(Name of Carrier)
BY _______________________
Attest (If a Corporation):
___________________________ , Secretary
(Corporate Seal)
Duplicate mailed to , Agent.
_____________________________________________
_____________________________________________
NOTE 1: In the blank space for the name of the carrier, there shall be shown, if the carrier be an individual, the individual name followed by the trade name, if any. If the carrier be a partnership, the correct names of all partners must be given, followed by the trade name, if any. If the carrier be a corporation, the correct corporate name must be used. (See Note 2.)
NOTE 2: The power of attorney shall be signed by the individual carrier, if the carrier be an individual, and shall be signed by all of the partners individually, if a partnership. If the carrier be a corporation, the power of attorney shall be signed by the president or vice president, attested by the secretary of the corporation, and the corporate seal shall be affixed. In all cases, the name of the carrier shall be identical with the name as it appears in the certificate of convenience and necessity issued by the Commission, or, in the event that such certificate shall not have been issued, the name of the carrier shall be identical with the name appearing in the application for such certificate.
REVOCATION NOTICE
__________________________
(Name of Carrier)
__________________________
(Post office address)
__________ , 19 _____
Know All Men by This Instrument:
Effective _____ , 19 _____ , power of attorney P.S.C.I. No. _____ , issued by _____ in favor of _____ is hereby cancelled and revoked.
_____________________
(Name of Carrier)
By ____________________
Attest (if a corporation): (Corporate Seal)
_____________________ , Secretary
Duplicate mailed to ______________________________________
(Name of Agent)
________________________
(Address)
________________________
(Date)
45 IAC 16-3-22
Transferred from the Indiana Utility Regulatory Commission ( 170 IAC 2-3-22) to the Department of State Revenue ( 45 IAC 16-3-22) by P.L. 72-1988, SECTION 12, effective July 1, 1988.