application are a true and accurate account of services performed. I further confirm that no costs included in this application that were invoiced by my consulting company are ineligible as listed in Minnesota Rules, Chapter 2890. / Consultant Signature Title Date **Attach additional certification page(s) if more than one consultant signature is required. Applicant signature and notarization not required on additional pages. APPLICATION PREPARER CONTACT INFORMATION (Preparer’s name) (Representing) Number Please send this application and accompanying documents to: Minnesota Department of Commerce Petrofund – 85 280 ST. PAUL, MN 651-539-1515 or 800-638-0418 This application form is effective JULY 1, 2018 – JUNE 30, 2019
application are a true and accurate account of services performed. I further confirm that no costs included in this application that were invoiced by my consulting company are ineligible as listed in Minnesota Rules, Chapter 2890. / Consultant Signature Title Date **Attach additional certification page(s) if more than one consultant signature is required. Applicant signature and notarization not required on additional pages. APPLICATION PREPARER CONTACT INFORMATION (Preparer’s name) (Representing) Number Please send this application and accompanying documents to: Minnesota Department of Commerce – Petrofund 85 280 ST. PAUL, MN 651-539-1515 or 800-638-0418 This application form is effective JULY 1, 2018 – JUNE 30, 2019
initial-application.docx