Appendix 5: Clean development mechanism approval application form

1. Project in brief

Project title:

Project participant:

Has the project been: denied approval by another Annex I DNA?

Yes / No

If yes, please provide the contact details of the DNA involved and reasons why approval was denied.

Has the project been given approval by the NZ DNA or another Annex 1 DNA?

Yes / No

If yes, please provide the contact details of the DNA involved.

2. Project participant (investor)

Name of the legal entity:

Company registration number (if applicable):

Name of authorised signatory:

Phone number:

Email address:

Postal address:

NZEUR holding account name:

NZEUR holding account number:

Years covered by this application:

Tonnes of CO2-e abatement from the project for the years covered by this application:

Volume of CERs during CP1:

3. Host party

Country:

Modalities of communication:

Project location:

Host party approval:

Date given: Internet link:

Emission Reduction Purchase Agreement signed:

Yes / No If yes, date:

4. Project in detail

Registration status:

UNFCCC reference number:

Sectoral scope:

Emission reductions in CO2-e per year:

Project summary description:

5. Attachments

Project design document

Yes / No Internet link:

Host party approval

Yes / No Internet link:

Validation report

Yes/No Internet link:

6. Checklist

Answered all relevant questions

Yes/No

Signed and dated declaration

Yes/No