3140-FM-WE0041 8/2009
    COMMONWEALTH OF PENNSYLVANIA
    DEPARTMENT OF ENVIRONMENTAL PROTECTION
    SAMPLE BANK AUTHORIZATION LETTER
    Signature Requirements on Collateral to be Processed are: President and
    Treasurer or Cashier (not Assistants). If it is not possible for you to get the
    signatures of personnel in the above bank positions, or if you cannot send us a
    bank signature authorization book, you may submit to us the following:
    On Bank Letterhead
    [Insert Date]
    “It is impractical to obtain the signature of the President and Treasurer or
    Cashier. Thus, the officer(s) in the below-listed positions in the bank, signing in
    such capacity, are authorized to execute a Letter of Credit and/or a Certificate of
    Deposit and that by doing so, they fully bind the bank under the terms of that
    Letter of Credit or Certificate of Deposit as fully and amply as if it had been
    signed by the President and Treasurer or Cashier of the bank:
    [List the officer titles/positions for which the bank authorizes
    persons signing in that capacity to execute the instrument as a
    substitute for the officer signing this letter.]
    Additionally, persons in the above positions will remain authorized to sign on
    behalf of [insert name of bank] until the Department of Environmental Protection
    is notified in writing otherwise.”
    Original Signature of President and
    Treasurer or Cashier of Bank
    Notarized
    Names and Titles Typed under Signatures

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