Fiscal/Compliance Forms Ability to Pay Form (Corporation) Ability to Pay Form (Individual) Ability to Pay Form (Public Entity) O.A.C. 3737-1-04.1 Affidavit Tank Installation/Removal Notification Form Tank Inventory Form Transfer of Ownership Form Claims Forms Certification Affidavit Claim Reimbursement Application Cost Pre-Approval Application - FPR Cost Pre-Approval Application - RAP Eligibility Application Hardship Status Application (Individual) Hardship Status Application (Corporation) Limited Power of Attorney for Signature Delegation Linked Deposit Application Listing of Invoices One-Year Claim Filing Deadlines Table Remediation System Disposition Form Remediation System Documentation Form These documents are provided in Adobe® Reader® PDF format. You can obtain the free Adobe® Reader® application by going to the Adobe website and downloading the appropriate file and installing on your computer.
Fiscal/Compliance Forms
Ability to Pay Form (Corporation)
Ability to Pay Form (Individual)
Ability to Pay Form (Public Entity)
O.A.C. 3737-1-04.1 Affidavit
Tank Installation/Removal Notification Form
Tank Inventory Form
Transfer of Ownership Form
Claims Forms
Certification Affidavit
Claim Reimbursement Application
Cost Pre-Approval Application - FPR
Cost Pre-Approval Application - RAP
Eligibility Application
Hardship Status Application (Individual)
Hardship Status Application (Corporation)
Limited Power of Attorney for Signature Delegation
Linked Deposit Application
Listing of Invoices
One-Year Claim Filing Deadlines Table
Remediation System Disposition Form
Remediation System Documentation Form
These documents are provided in Adobe® Reader® PDF format.
You can obtain the