Section 170 IAC 8.5-3-3 - Sample CTA application and personal guarantee formsAuthority: IC 8-1-1-3; IC 8-1-2-47; IC 8-1-2-69; IC 8-1-2-89
Affected: IC 8-1-1-3; IC 8-1-2-89
Sec. 3.
(a) The application form is as follows: Click here to view Image
Click here to view Image
NOTES:
1. If applicant is not a corporation, appropriate changes in the application, including the signature thereto, should be made.2. If rural areas in more than one county are covered by the application, designate "Exhibit A-Part," etc., or "Exhibit B-Part 1," etc., as applicable.3. Immediately below each signature the name of the person signing shall be typed in. (b) The personal guarantee form is as follows: Click here to view Image
Click here to view Image
*Name and position of an officer of corporation making this guarantee.
**Name of organization sponsoring the development requiring sewage disposal service.
***Name of sewage disposal services corporation.
Indiana Utility Regulatory Commission; Service for Utilities Rendering Sewage Disposal Service in Ind; Rule 19; filed Dec 9, 1981, 10:20 a.m.: 5 IR 22; readopted filed Jul 11, 2001, 4:30 p.m.: 24 IR 4233; readopted filed Apr 24, 2007, 8:21 a.m.: 20070509-IR-170070147RFA; filed Sep 13, 2007, 1:58 p.m.: 20071010-IR-170070235FRA; readopted filed Aug 2, 2013, 2:16 p.m.: 20130828-IR-170130227RFAReadopted filed 4/11/2019, 9:04 a.m.: 20190508-IR-170190136RFA