Title 46

PART 68 APPENDIX A



Appendix A to Subpart A of Part 68 - Oath for Qualification of Corporation as a Citizen of the United States Under the Act of September 2, 1958 (46 U.S.C. app. 883-1)

46:2.0.1.3.24.1.1.11.2 : Appendix A

Appendix A to Subpart A of Part 68 - Oath for Qualification of Corporation as a Citizen of the United States Under the Act of September 2, 1958 (46 U.S.C. app. 883-1) Department of Homeland Security, U.S. Coast Guard Oath for Qualification of Corporation as a Citizen of the United States Under the Act of September 2, 1958 (46 U.S.C. app. 883-1) Corporation: Name Address 1

1 Show principal place of business of corporation.

State where incorporated Affiant: Name Address Company Title or capacity

I, the affiant named above, swear that I am legally authorized to make this oath on behalf of the corporation, that a majority of the officers and directors of the above-named corporation are citizens of the United States, as shown by the attached listing incorporated in and made a part of this oath which truly and correctly names all such officers and directors, giving the home address and citizenship of each; that not less than 90 percent of the employees of the corporation are residents of the United States; that the corporation is engaged primarily in a manufacturing or mineral industry in the United States or in a territory, district or possession thereof; that the aggregate book value of the vessels owned by the corporation does not exceed 10 percent of the aggregate book value of the assets of the corporation; and that the corporation purchases or produces in the United States, its territories or possessions not less than 75 percent of the raw materials used or sold in its operation. 2

2 Attach the required list of the names of all officers and directors of the corporation, giving the home address and citizenship of each.

The above named corporation fails to qualify as a citizen within the meaning of § 67.39(c) of this chapter by reason of: 3

3 Check appropriate line or lines.

___Non-citizen President ___Non-citizen Chairman of Board ___Failure to meet quorum requirements ___Failure to meet stock ownership requirements Signature

Subscribed and sworn to before me on the day and year shown

(Notary Public) Date [CGD 80-107, 47 FR 27511, June 24, 1982, as amended by USCG-2002-13058, 67 FR 61279, Sept. 30, 2002; USCG-2003-14505, 68 FR 9535, Feb. 28, 2003. Redesignated and amended by USCG-2007-28098, 71 FR 61418, 61419, Oct. 18, 2006]


Appendix A to Subpart B of Part 68 - Oath for Qualification of a Not-For-Profit Oil Spill Response Cooperative

46:2.0.1.3.24.2.1.8.4 : Appendix A

Appendix A to Subpart B of Part 68 - Oath for Qualification of a Not-For-Profit Oil Spill Response Cooperative Department of Homeland Security, U.S. Coast Guard Oath for Qualification of a Not-For-Profit Oil Spill Response Cooperative [46 U.S.C. 12106(d)] Cooperative: Name Address Jurisdiction where incorporated or organized Affiant: Name Address Cooperative Title or Capacity

I, the affiant, swear that I am legally authorized to make this oath and hold the capacity so bestowed upon me as ____, on behalf of the _______ cooperative and its members, that it is a not-for-profit cooperative, and that it is engaged in training for, carrying out, or supporting oil spill cleanup operations or related research activities.

That all members of the cooperative who may use the letter of qualification issued to this cooperative are truly and correctly named, including home address and citizenship of each on the attached listing incorporated in and made a part of this oath.

Signature Subscribed and sworn to before me on the day and year shown. (Notary Public) Date [CGD 90-055, 57 FR 7642, Mar. 3, 1992, as amended by USCG-2003-14505, 68 FR 9535, Feb. 28, 2003. Redesignated by USCG-2007-28098, 71 FR 61418, Oct. 18, 2006]