Mindful Gas Decommissioning Compensation Request Form for Workshop Host & Outreach Support

Please fill out this form to share comments with the Mindful Gas Decommissioning Project Team.

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* 1. Name

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* 2. Title

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* 3. Organization

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* 4. Mailing Address and Email Address

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* 5. Phone Number

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* 6. Tax Identification Number / Social Security Number

Please fill out a Form W-9 and email it to: cici.vu@dnv.com
W-9 Form can be found at: https://www.irs.gov/pub/irs-pdf/fw9.pdf

*Please allow up to 30 business days for disbursement to be processed.

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* 7. Do you require food or childcare needs during the meeting? We can provide up to $250 for accommodations.

Yes

No