36 CFR Part 14, Appendix A to Part 14

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View PDF at GPO Pt. 14, App. A
Appendix A to Part 14
Where necessary, these forms should be modified so as to be appropriate to the applicant (corporation, association, or individual), to the act involved, and to the nature of the project.
Form
References should be made to the appropriate section of the regulations to determine when each of the forms is required.
Form No. 2 may be signed by any officer or employee of the company who is authorized to sign it. However, if it is executed by a person other than the President, it must be accompanied by a certified copy of the minutes of the Board of Directors meeting or other document authorizing such signature unless such certified copy has already been filed in the case.
Forms 1 and 2 to be placed on maps. See § 14.25(a)(7).
Engineer's Statement
(Form 1)
_____(Name of engineer) states he is by occupation a _____(Type of engineer) employed by the _____(Company) to make the survey of the _____(Kind of works) as described and shown on this map; that the survey of said works made by him (or under his supervision) and under authority, commencing on the ______ day of _______ 19__ and ending on the _______ day of _______, 19__; and that such survey is accurately represented upon this map.
__________
Engineer
Applicant's Certificate
(Form 2)
This is to certify that _____ (Engineer), who subscribed the statement hereon, is the person employed by the undersigned applicant to prepare this map, which has been adopted by the applicant as the approximate final location of the works thereby shown, and that this map is filed as a part of the complete application, and in order that the applicant may obtain the benefits of _____(Cite statute); and I further certify that the right-of-way herein described is desired for
(state purpose)
(Seal)
Signature of Applicant
Title
Company
Attest:

Title 36 published on 2014-07-01

no entries appear in the Federal Register after this date.