Acid Rain Program under Title IV of the Clean Air Act Amendments

Acid Rain Program under Title IV of the Clean Air Act Amendments (Renewal)

subscriber_agreement_form

Acid Rain Program under Title IV of the Clean Air Act Amendments

OMB: 2060-0258

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Subscriber Agreement



  1. I agree to maintain the security of the UserID and Password assigned to me by U.S. EPA for use of the CAMD Business System, in order to prevent disclosure of this information to anyone.


  1. I agree that, if I have any reason to believe that the security of the UserID or Password has been compromised, I will immediately inform U.S. EPA by calling (202) 343-9157 or (202) 343-9168.


  1. I agree to maintain an email account; if any email sent to me by U.S. EPA is returned as undeliverable, I will explain why this occurred when requested by U.S. EPA.


  1. I agree to notify U.S. EPA if I cease to represent the regulated entity specified below, by sending an email to [email protected].


  1. I agree that I will be held as legally bound, obligated, and responsible for any submission I make using the CAMD Business System as I would be by making such submission in hardcopy form with my handwritten signature as certification.


  1. I agree that I will be held as legally bound, obligated, and responsible for any submission made using the CAMD Business System by an agent whom I have authorized to act on my behalf.




SIGNATURE:


PRINTED NAME:


TITLE:


COMPANY:


EMAIL ADDRESS:


DATE:


Please send completed forms to:


Street Address (overnight mail and package delivery) Regular or certified mail


U.S. EPA U.S. EPA

Clean Air Markets Division Clean Air Markets Division

1310 L Street, NW 1200 Pennsylvania Avenue, NW

ATTN: Karen VanSickle, Room 209 Mail Code 6204J, Karen VanSickle

Washington, DC 20005 Washington, DC 20460

Telephone: (202) 343-9220

File Typeapplication/msword
AuthorEPA
Last Modified Byctsuser
File Modified2009-07-17
File Created2009-07-17

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