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ANNUAL COMPLIANCE CERTIFICATION December 2016INSTRUCTIONSUse this form to certify compliance with permit terms and conditions on an annual basis as required by your Title V Operating Permit, issued

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What is use this form to?

Use this form to report your annual income.

Who is required to file use this form to?

Anyone who received income during the year must file this form.

How to fill out use this form to?

You can fill out this form online or mail it in with all required documentation.

What is the purpose of use this form to?

The purpose of this form is to report your income to the tax authorities.

What information must be reported on use this form to?

You must report all sources of income, including wages, interest, and dividends.