Sunteți pe pagina 1din 4

ContinuationSheet

InformationofAffiliatesorSubsidiaryEntities
Instructions:
FillouttheformorindicateN/Awheretheinformationisnotapplicable.
UseComplementarySheet(CEPRZ01)ifadditionalspaceisrequired.

NewInformation
1.
2.
3.
4.

InformationUpdate

ElectricPowerCompanyName:

Applicant/PresenterName:

Titleofthesupplementedform:

Dateofthesupplementedform:

A. AffiliateorSubsidiaryEntityGeneralInformation
1. CompanyName:
2.
OrganizationalForm:

Corporation

LimitedLiabilityCompany

Society
Other:
3. Jurisdictionwhereitwasorganized:
4. IdentificationNumberoftheDepartmentofStateoftheCommonwealthofPuertoRico:

5. RegistryInformationinotherjurisdictions:
(Includeidentificationorregistrynumbersfromotherjurisdictionsandtheentitiesthathaveissuedsuchnumbersandguardtheregistryinformation.)

B. InformationofOfficesinPuertoRico
1. PrincipalOffice
a.

PhysicalAddress:

b.
PostalAddress:

2. SecondaryOffice
a.

PhysicalAddress:

CEPRB02(Rev.August2015)ContinuationSheetforAffiliateorSubsidiaryEntities
Reference:RegulationonCertification,AnnualFees,andOperationalPlansforElectricPowerCompaniesinPuertoRico,RegulationNo.8618.

Page1of4

b.
PostalAddress:

SecondaryOffice
a.

PhysicalAddress:

b.
PostalAddress:

SecondaryOffice
a.

PhysicalAddress:

b.
PostalAddress:

C. AddressesforReceiptofNotifications
(IndicatetheaddresseswherenotificationsofmattersbeforetheCommissionaretobereceived.)
1.

PhysicalAddress:

2. Authorizedpersontoreceivenotificationspersonally:
3.

PostalAddress:

4. Email:

D. InformationforDesignatedContactbeforetheEnergyCommission
1. Name:

3.
PhysicalWork
Address:
4.

PostalWork
Address:

5. OfficePhone:
7. Email:

2. Position:

6.

MobilePhone:

E. InformationoftheCompanysResidentAgent
1. Name:
2.
PhysicalAddress:
3. PostalAddress:

CEPRB02(Rev.August2015)ContinuationSheetforAffiliateorSubsidiaryEntities
Reference:RegulationonCertification,AnnualFees,andOperationalPlansforElectricPowerCompaniesinPuertoRico,RegulationNo.8618.

Page2of4

4. OfficePhone:
6. Email:

5.

MobilePhone:

F. InformationofPartners,Directors,MembersoftheGoverningBody,andElectric
ServiceCompanyOfficials
1. Name:
PhysicalAddress:

OfficePhone:

Email:

PostalAddress:

2. Name:
PhysicalAddress:

OfficePhone:

Email:

PostalAddress:

3. Name:
PhysicalAddress:

OfficePhone:

Email:

PostalAddress:

4. Name:
PhysicalAddress:

OfficePhone:

Email:

PostalAddress:

5. Name:

Position:

MobilePhone:

Position:

MobilePhone:

Position:

MobilePhone:

Position:

MobilePhone:

Position:

CEPRB02(Rev.August2015)ContinuationSheetforAffiliateorSubsidiaryEntities
Reference:RegulationonCertification,AnnualFees,andOperationalPlansforElectricPowerCompaniesinPuertoRico,RegulationNo.8618.

Page3of4

PhysicalAddress:

OfficePhone:

Email:

PostalAddress:

6. Name:
PhysicalAddress:

OfficePhone:

Email:

PostalAddress:

MobilePhone:

Position:

MobilePhone:

Annexes:(MarkthedocumentsincludedwiththeContinuationSheetforAffiliateorSubsidiaryEntities)
ComplementarySheet(CEPRZ01).
Other:

CEPRB02(Rev.August2015)ContinuationSheetforAffiliateorSubsidiaryEntities
Reference:RegulationonCertification,AnnualFees,andOperationalPlansforElectricPowerCompaniesinPuertoRico,RegulationNo.8618.

Page4of4

S-ar putea să vă placă și