Free INSTRUCTIONS FOR COMPLETING FORM LC-1 - Indiana

AMENDMENT TO IRREVOCABLE LETTER OF CREDIT
State Form 50622 (R/12-04)

INDIANA DEPARTMENT OF NATURAL RESOURCES DIVISION OF RECLAMATION

Form LC-2 INSTRUCTIONS: 1. Submit One (1) Original and One (1) Copy

FOR OFFICIAL USE

Irrevocable Letter of Credit Number Amendment Number: Name and Address of Issuing Bank:

Date

Name and Address of Permittee:

Beneficiary:

Department of Natural Resources Division of Reclamation RR 2 Box 129 Jasonville, Indiana 47438 , for the account of the Permittee in favor of the Beneficiary, is hereby amended as follows:

The above mentioned Letter of Credit originally dated Permit No. , Pit Name:

(Check the appropriate box(es))



The total amount is (increased) (decreased) by the amount of: ($ Dollars, from the previous amount of: ($ Dollars, to a new total of: ($ Dollars. ) ) )



Other

All other terms and conditions of the above Letter of Credit remain unchanged. This amendment is to be considered a part of the above Letter of Credit and is to be attached thereto.

Printed Name and Official Title Authorized Representative Issuing Bank Signature Authorized Representative Issuing Bank Accepted: Date Authorized Signature Division of Reclamation Department of Natural Resources

AMENDMENT TO IRREVOCABLE LETTER OF CREDIT
State Form 50622 (R/12-04)

INDIANA DEPARTMENT OF NATURAL RESOURCES DIVISION OF RECLAMATION

Form LC-2 INSTRUCTIONS: 1. Submit One (1) Original and One (1) Copy

FOR OFFICIAL USE

Irrevocable Letter of Credit Number Amendment Number: Name and Address of Issuing Bank: (4)

(1) (3)

Date

(2)

Name and Address of Permittee: (5)

Beneficiary:

Department of Natural Resources Division of Reclamation RR 2 Box 129 Jasonville, Indiana 47438 (6) , for the account of the Permittee

The above mentioned Letter of Credit originally dated Permit No. (7) , Pit Name: (8)

in favor of the Beneficiary, is hereby amended as follows:

(Check the appropriate box(es))



The total amount is (increased) (decreased) by the amount of: (9) Dollars, from the previous amount of: (11) Dollars, to a new total of: (13) Dollars. ($ ($ ($ (10) ) ) )

(12)

(14)



Other

All other terms and conditions of the above Letter of Credit remain unchanged. This amendment is to be considered a part of the above Letter of Credit and is to be attached thereto.

(15) Printed Name and Official Title Authorized Representative Issuing Bank (16) Signature Authorized Representative Issuing Bank Accepted: (17) Date (18) Authorized Signature Division of Reclamation Department of Natural Resources

INSTRUCTIONS FOR COMPLETING FORM LC-2 AMENDMENT TO IRREVOCABLE LETTER OF CREDIT
This form may only be used for bonding permanent program permits issued in accordance with I.C. 14-34. Bond for permits issued in accordance with I.C. 13-4-6 must be submitted on a different form. Do not make any entries in the space identified "FOR OFFICIAL USE". The following explanations are numbered to correspond to the numbered items on the attached Form LC-2:

(1) (2) (3) (4) (5)

Letter of Credit Number ­ Insert the number of the original Letter of Credit submitted on Form LC-1 to be amended. Date ­ Insert the date this Amendment is signed. Amendment Number ­ This number is to be selected and assigned by the bank and should reflect the numerical sequence of this amendment with respect to any previous amendments submitted. Name and Address of Issuing Bank ­ Type or print the name and address of the bank issuing the Letter of Credit. This is the address to which the Division of Reclamation will send all correspondence concerning this Letter of Credit. Name and Address of Permittee ­ Type or print the name and address of the Permittee. The name must be identical to the name used in the permit. This is the address to which the Division of Reclamation will send all correspondence concerning this Letter of Credit. Original Date ­ Insert the date the original Letter of Credit was signed. Permit Number ­ This number is assigned by the Division of Reclamation and should be inserted in this blank. Pit Name ­ Type or print the name of the mine.

(6) (7) (8)

Indicate by placing an "X" in the box beside the applicable section: * The first box is to be checked if the amount of the Letter of Credit is to be increased or decreased. Please circle whether the amount will be increased or decreased. * The second box is to be checked if there is another reason for issuance of this amendment to the original Letter of Credit.

(9) (10) (11) (12) (13) (14)

Amount ­ Type in words the amount of the increase or decrease of the Letter of Credit Amount ­ Type in figures the amount of the increase of decrease of the Letter of Credit. Amount ­ Type in words the amount of the previous Letter of Credit. Amount ­ Type in figures the amount of the previous Letter of Credit. Amount ­ Type in words the amount of the new total. Amount ­ Type in figures the amount of the new total.

(15 & 16) Must be completed by an Authorized Responsible Official of the issuing Bank.

Please be sure to SUBMIT ONE (1) ORIGINAL AND ONE (1) COPY of the fully executed document. Upon acceptance of the document, the Division of Reclamation will retain the original document, a copy will be returned to the bank and a copy will be sent to the permittee.