(Name of carrier in full)
Date ___, 19 ___
Pa. H 1 No. (for household goods tariffs) or
Pa. P 1 No. (for passenger tariffs)
KNOW ALL MEN BY THESE PRESENTS:
That the (name of the carrier) has made, constituted, and appointed, and by these presents does make, constitute, and appoint (name of principal agent appointed) is true and lawful attorney and agent for the said carrier, and in its name, place, and stead, (1) for it alone, and (2) for it jointly with other carriers to receive concurrences in, and to file, rate schedules and supplements thereto, as required of carriers by the Public Utility Law and by regulations established by the Pennsylvania Public Utility Commission thereunder, for the period of time, the traffic, and the territory specified below, and to accept service of any notice, order or process for it and on its behalf which may be issued in proceedings before the Commission involving the lawfulness of rates, charges, classifications or practices contained or proposed in tariffs or schedules so filed:
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And the said (name of carrier) does hereby give and grant unto its said attorney and agent full power and authority to do and perform all and every act and thing above specified as fully, to all intents and purposes, as if the same were done and performed by the said carrier, hereby ratifying and confirming all that its said attorney and agent may lawfully do by virtue hereof, and assuming full responsibility for the acts and neglects of its said attorney and agent hereunder. And further, That the (name of carrier) has made, constituted and appointed, and by these presents does make, constitute and appoint as alternate (name of alternate agent appointed) its true and lawful attorney and agent, for said carrier and in its name, place and stead, (1) for it alone, and (2) for it jointly with other carriers, in case and only in case of death or disability of the said (here insert name of principal agent) to do and perform the same acts and exercise the same authority as hereinabove granted to (here insert name of principal agent.)
In witness whereof the said carrier has caused these presents to be signed in its name by its president and to be fully attested under its corporated seal by its secretary, at ___ in the State of ___, on this ___ day of ___, in the year of our Lord nineteen hundred and ___.
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(Name of carrier)
By ______________________________________
(Name of officer)
________________________________________
(Title of officer)
ATTEST (if a corporation)
____________ Secretary
52 Pa. Code § 23.124
The provisions of this § 23.124 amended under the Public Utility Code, 66 Pa.C.S. § 501.