Forms

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Reimbursement Applications

• Original Application (Tank Owner Operator)
• Original Application (Non-Responsible Party)
• Supplemental Application

Reimbursement Cost Requests (RCR)

• Reimbursement Cost Request

Policy #29 - Tank Removal Costs Application

• Policy #29 Tank Removal Costs Guidance
• Policy #29 Application

Affidavits

• Proof of Payment Affidavit (POP)
• Waiver of Policy #8
• Work Performed by Applicant
• Equipment or Materials Purchased by Applicant
• Emergency Generator Tanks

Other Forms

• Certificate of Eligibility
• CPA Certification: Proof of Payment
• Request to Transfer Fund Eligibility
• Request for Waiver of Deductible Incentive
• W-9 Request Form
• Protest of Fund Payment Report