Updated Application Form for Carbon Trading – Tanzania National Carbon Monitoring Centre (NCMC) | Carbon Tanzania

Name of the Project *

Project Application Reference Number *

Date of Application: *

Name the type of Carbon Credit Mechanism or Approach: *

PROJECT DETAILS

A. Project Description, Type, Location, Site, Size and Schedule

General Description

A.1 Brief Project description and proposed activities *

A.2 Is the project proponent the Managing Authority *

YES
NO
Remarks

IF NO - Attach the support letter from the Managing Authority *

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Write Remarks *

Project Proponent Registering the PCN

A.3 Name *

A.4 Organizational Category *

(a) Central Government (Ministries, Departments and Agencies)
(b) Local Government (City Council, Municipal Council District Council, Town Council, Mtaa and Village Council)
(c) Private (individual, company)
(d) Civil Society Organization
(e) Other (Specify)

A.4 Specified Organizational Category

A.5 Other function(s) of the project developer in the project (Choose one or more) *

(a) Sponsor
(b) Intermediary
(c) Technical advisor

A.6 Summary of Relevant Experience *

A.7 Address *

Address Line 1

City

State / Province / Region

Country

A.8 Contact Person

A.9 Telephone / Fax *

A.10 E-mail *

Web Address

Project Managing Authority

A.11 Name *

A.12 Organizational Category6

(a) Government
(b) Government agency
(c) Municipality
(d) Private company
(e) Others (Specify)

A.12 Specified Organizational Category

A.13 Address *

Address Line 1

Address Line 2

City

State / Province / Region

Country

A.14 Contact Person *

A.15 Telephone / Fax *

A.16 Email *

Website / URL

Project sponsor(s) or Upfront Buyer Financing the Project

(List and provide the following information for all project sponsors)

A.17 Name *

A.18 Organizational Category

(a) Government
(b) Government agency
(c) Municipality
(d) Private company
(e) Others (Specify)

A.18 Specified Organizational Category

A.19 Address *

Address Line 1

City

State / Province / Region

Country

Website / URL

A.20 Main activities *

A.21 Summary of the Financials *

Type of Project

(List and provide the following information for all project sponsors)

A.22 Greenhouse Gases Targeted *

A.22 Greenhouse Gases Targeted (Choose one or more)

Carbon dioxide (CO2)
Methane (CH4)
Nitrous oxide (N2O)
Hydrofluorocarbons (HFCs)
Perfluorocarbons (PFCs)
Sulfur hexafluoride (SF6)
Nitrogen trifluoride (NF3)

A.23 Type of activities *

Location of the Project

A.24 Region(s) *

A.25 District(s) *

A.26 Division(s) *

A.27 Ward(s) *

A.28 Village(s) *

A.29 Precise location (GPS coordinates) *

For Forest Carbon Trade Projects, State Management and Governance

A.30 Approved *

Management Plan

A.31 Approved By-Laws *

A.32 Free from land disputes and conflicts *

A.33 Proposed, Declaration or Gazettement if applicable *

A.34 Village land-use plans if applicable (for Village Land Forest Reserves) *

A.35 Does the project require Environmental Impact Assessment (EIA) as per the Forest Act Sect.18 (1)? *

Expected schedule

A.36 Earliest Project Start Date (Year in which the project will be operational)

A.37 Estimate of time required before becoming operational after approval of the PCN *

A.38 Year of the first expected CERs/VERs delivery *

A.39 Project lifetime (Number of years)

A.40 Current status or phase of the project/activity *

B. EXPECTED ENVIRONMENTAL AND SOCIAL BENEFITS

Environmental Benefits

B.1 Estimates of emission reduction avoidance or removal (In metric tonnes of CO2 equivalent – t CO2e. Please attach spreadsheet.) Provide estimates from REDD activities separately *

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B.2 Baseline scenario *

Is Project REDD+ ?

If REDD+ Projects , Mention the main Drivers and Agents for Deforestation and how the Project will address them. *

B.3 Existing vegetation and land use *

B.4 Environmental Benefits *

B.4.a Local Benefits *

B.4.b National Benefits *

B.4.c Global Benefits *

B.5 Consistency between the project and the environmental priorities of the Host Country *

Socio-economic Benefits

B.6 How will the project improve the welfare of the community involved in it or surrounding it. What are the direct effects which can be attributed to the project and which would not have occurred in a comparable situation without that project? *

B.7 Is there any Benefit sharing arrangement in place? *

If YES - Attach *

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B.8 Are there other Benefits? *

C. FINANCE

Project costs

C.1 Preparation costs (US$ million ) *

C.2 Establishment costs (US$ million ) *

C.3 Other costs (explain) *

C.4 Total project costs (US$ million ) *

DECLARATION

I do hereby declare that the information provided in this application are true to the best of my knowledge.

Name *

Qualification *

Signature *

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Date

Official Seal *

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Witnessed by

Name *

Qualification *

Signature *

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Date *

ATTACHMENTS

Please Attach the following Documents

1. Memorandum and Articles of Association *

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2. Certificate of incorporation/ Compliance Certificate *

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3. Tax Identification Number Certificate *

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4. Business License *

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5. Current Annual Return filled BRELA *

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