Appendix 101.APPENDIX C

Ill. Admin. Code tit. 35, § 101.APPENDIX C

Withdrawal of Appearance Form

AUTHORITY: Implementing Sections of the Environmental Protection Act [415 ILCS 5/5, 7.1, 7.2, 26, 27, 28, 29, 31, 32, 33, 35, 36, 37, 38, 40, 40.1, 40.2, 41, and 58.7] and authorized by Sections 26 and 27 of the Act [415 ILCS 5/26 and 27] and Section 25-101 of the Electronic Commerce Security Act (Repealed by P.A. 102-38).POLLUTION CONTROL BOARD

BEFORE THE ILLINOIS POLLUTION CONTROL BOARD

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Applicable Caption )

(see Appendix A) ) docket number

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NOTICE OF WITHDRAWAL OF APPEARANCE

I hereby give notice of withdrawal of my appearance as representative of ABC Company in this proceeding.

Attorney's Name

Name of Attorney and Firm

Address

Telephone Number