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

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Name of the Project *

Project Application Reference Number *

Type of credit mechanism or approach (Tick the appropriate) *

(a) Clean Development Mechanism (CDM)
(b) Voluntary Carbon Credit Trading (VCCT)
(c) Joint Credit Mechanism (JCM)
(d) Others

Other type of credit mechanism or approach *

A. Project Details (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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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

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.9 Telephone / fax *

A.10 E-mail *

Web Address

A.8 Contact person *

Project Managing Authority

A.11 Name *

A.12 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

A.13 Address *

Address Line 1

City

State / Province / Region

Country

A.14 Contact person *

A.15 Telephone / fax *

A.16 E-mail *

Web Address

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) Civil Society Organization

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 *

CO2
CH4
N2O
CFCs

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 *

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 *

A.40 Current status or phase of the project *

B. Expected Environmental and Social Benefits

Environmental Benefits

B.1 Estimate of carbon sequestered or conserved (In metric tonnes of CO2 equivalent – t CO2e. Please attach spreadsheet) *

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Provide estimates from REDD activities separately // Up to and including e.g. 2022: xx t CO2e // Up to and including e.g. 2023: xx t CO2e

B.2 Baseline scenario *

If REDD activity, mention the main drivers and agents for deforestation and how the project will address them *

If REDD activity, mention the maB.3 Existing vegetation and land use in drivers and agents for deforestation and how the project will address them (copy) *

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? *

Indicate the number of communities and the number of people that will benefit from this 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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Official Seal *

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Date / Time

Date

Time

Witnessed by

Name *

Qualification *

Date / Time *

Date

Time

Signature *

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