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Department of Environmental Protection Division of Air Resource Management STATEMENT OF COMPLIANCE TITLE V SOURCE REASON FOR SUBMISSION (Check one to indicate why this statement of compliance is being
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How to fill out a statement of compliance form:

01
Start by carefully reading the instructions: Before filling out the statement of compliance form, it is essential to thoroughly read the provided instructions. Familiarize yourself with the requirements and any specific information that needs to be included.
02
Provide accurate and complete information: The statement of compliance form typically requires personal or organizational details, such as name, address, contact information, and any relevant identification numbers. Make sure to enter all the required data accurately and ensure that no important fields are left blank.
03
Understand the compliance requirements: The statement of compliance form aims to attest that the individual or organization complies with certain regulations, laws, or standards. Familiarize yourself with the specific compliance requirements applicable to your situation. This may include safety regulations, environmental standards, or legal obligations, among others.
04
Include supporting documentation if required: Depending on the nature of the compliance being addressed, additional supporting documentation may be necessary. This can include permits, licenses, certificates, inspection reports, or any other relevant evidence that demonstrates your compliance. Ensure all required documents are attached or referenced appropriately.
05
Provide an honest and accurate statement: The statement of compliance form requires an affirmation of your compliance status. It is crucial to provide an honest and accurate statement, as false or misleading information can lead to legal consequences or damage your reputation. Take the time to carefully review your statement before submitting it.

Who needs a statement of compliance form:

01
Businesses and organizations: Many industries and sectors require businesses and organizations to complete a statement of compliance form. This may include construction companies, healthcare facilities, manufacturing plants, educational institutions, or any other entity that needs to demonstrate compliance with specific regulations or standards.
02
Individuals in regulated professions: Certain professionals, such as lawyers, doctors, engineers, or accountants, may be required to complete a statement of compliance form to ensure they comply with professional codes of ethics, rules, or standards. This helps maintain the integrity and trustworthiness of these professions.
03
Contractors or service providers: When bidding on contracts or providing services to clients, contractors and service providers may be asked to submit a statement of compliance form. This assures the clients that the contractor or service provider meets all the necessary legal, safety, or quality requirements to fulfill the contract.
In summary, anyone who needs to demonstrate their adherence to specific regulations, standards, or codes may be required to fill out a statement of compliance form. Whether you are a business, individual in a regulated profession, or a contractor/service provider, it is important to understand the purpose of the form and diligently complete it with accurate information.
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The statement of compliance form is a document that verifies compliance with certain rules or regulations.
Individuals or organizations that are subject to specific regulations requiring compliance reporting.
The form typically requires providing information about the entity's activities and confirming compliance with relevant regulations.
The purpose of the form is to ensure transparency and accountability in regulatory compliance.
Typically, information about the entity's operations and activities, along with confirmation of compliance with relevant regulations.
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