RUS Form 675

RUS675.PDF

Telecommunications System Construction Policies and Procedures

RUS Form 675

OMB: 0572-0059

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U.S. Department of Agriculture
Rural Utilities Service

CERTIFICATE OF AUTHORITY
INSTRUCTIONS-Submit one copy to RUS. See 7 CFR 1744 (Telecommunications) and RUS Bulletin 26-1 (Electric)

In conformity with the requirements of the Rural Utilities Service (RUS), and in accordance with the
resolution of the board of directors of the

BORROWER'S NAME

BORROWER'S ADDRESS

attached hereto, adopted at a meeting of the board, held

at which a quorum

, 20

of the board was present, the officers and manager, whose signatures appear below, have been authorized
to sign the following RUS forms in connection with requisitioning and accounting for Loan Funds:
(Check One)
RUS Form No.
481
595

TITLE
FINANCIAL REQUIREMENT STATEMENT (Telecommunications)
FINANCIAL REQUIREMENT & EXPENDITURE STATEMENT (Electric)

This certification is to remain in force until rescinded by resolution of the board of directors
and notification of such action to RUS.

TITLE

NAME (TYPE OR PRINT)

SIGNATURE

TITLE

NAME (TYPE OR PRINT)

SIGNATURE

TITLE

NAME (TYPE OR PRINT)

SIGNATURE

BORROWER'S NAME

SIGNATURE OF PRESIDENT

DATE

RUS Form 675 (Rev. 01-97)

SIGNATURE OF SECRETARY

Expires: 12/31/2015


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File Modified2014-04-22
File Created2005-03-07

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