Tracking Data STATE OF NEVADA Date Legal Structure GOVERNOR’S OFFICE OF ENERGY Assembly District Senate District Project Type Project Location kWh Total Project Cost 1. Applicant/Co-Applicant/Guarantor Information: Name of Owner/Applicant Telephone Email Mailing Address City State Zip Code Type of Business Tax ID Number Date Organized Is business legally organized in the State of Nevada? Principals/Owners Telephone Email Ownership % Physical Address City State Zip Code Years in Management Social Security Number Date of Birth Principals/Owners Ownership % Telephone Physical Address City State Zip Code Years in Management Social Security Number Date of Does Applicant/Co-Applicant/Guarantor have loans with the State of Nevada? If yes, explain: 2. Project Location: Attach maps of appropriate scale to show clearly the location of the proposed project with respect to other identifiable topographical or geographical features in the area of the project; location legal information such as assessor’s parcel number (APN), proof of ownership, rights-of-way, easements or agreements showing that the applicant holds or is able to acquire all land, other than public land, or acquire interests therein and any water rights necessary for the construction of the proposed project (without the use of loan fund proceeds); Provide copies of any liens on the property. Legal Description of Property* APN County Physical Address/Location City Zip Code *Insert or attach a complete metes and bounds legal description if available and APN
STATE OF NEVADA GOVERNOR’S OFFICE OF ENERGY Tracking Data Date Legal Structure Assembly District Senate District Project Type Project Location kWh Total Project Cost 1. Applicant/Co-Applicant/Guarantor Information: Name of Owner/Applicant Telephone Email Mailing Address City State Zip Code Type of Business Tax ID Number Date Organized Is business legally organized in the State of Nevada? Principals/Owners Ownership % Telephone Email Physical Address City State Zip Code Years in Management Social Security Number Date of Birth Principals/Owners Ownership % Telephone Physical Address City State Zip Code Years in Management Social Security Number Date of Does Applicant/Co-Applicant/Guarantor have loans with the State of Nevada? If yes, explain: 2. Project Location: Attach maps of appropriate scale to show clearly the location of the proposed project with respect to other identifiable topographical or geographical features in the area of the project; location legal information such as assessor’s parcel number (APN), proof of ownership, rights-of-way, easements or agreements showing that the applicant holds or is able to acquire all land, other than public land, or acquire interests therein and any water rights necessary for the construction of the proposed project (without the use of loan fund proceeds); Provide copies of any liens on the property. Legal Description of Property* APN County Physical Address/Location City Zip Code *Insert or attach a complete metes and bounds legal description if available and APN