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I SECTION VI. APPLICATION CHECKLIST (Please read carefully) I Please review your application for completeness, clarity, and legibility prior to submittal. The following checklist will ensure that your application is complete and processed in the most expedient manner possible. Your application will I l1Q1 be reviewed until it is complete and all relevant materials are received. Improperly completed or incomplete applications may be returned, resulting in a processing delay. I All applications for reimbursement mu.st be submitted with the following infonnation. Complete the application checklist to . detennine if your application is complete. 1. X Proof of payment for all claimed expenses (Section I, Page 3, Item 7). ' 2. X Annual tank registration fees due since September 1, 1987 have been paid in full (Section I, Page 3, Item 9). I 3. X Certification Affidavit signed by the Owner/Operator, Application Preparer, and Prime Contractor and/or Prime Corrective Action Specialist (Section I, Page 5). I 4. X A technical report addressing the remedial activities for which you are seeking reimbursement has been I received by J!ød¡ the appropriate TNRCC Regional Field Office and the PST Division, Responsible Party Remediation Section in Austin. I 5. X R~lease Incident Summary (Section n, Pages 7-8). I 6. X Technical Report Summary (Section ill, Pages 9). I 7. X Total Reimbursement Request (Section N, Page 10-12). 8. X Reimbursement Claim Summary (Section V, Page 13). I 9. X Reimbursement Activity Summary Cost Sheet (Schedule A) for each activity with attached invoices, time I sheets, subcontractor invoices, and preapproval documentation (Section VI, Attachments). 10. [J If applicable, the Notice of Assignment and Assignment Contract (including proof of security interest such t as a copy of the Mechanics Lien or Deed of Trust, etc.) (Section I, Page 3, Item 8). I I Applications will JWt be reviewed until they are complete and all relevant materials are received. I I 'INRCC APPUCA TION FOR REIMBURSEMENT E-Z FORM 14 1NRCC-O230-EZ (Revised 09-01-95)