| APPENDIX C |
| CONSENT TO PUBLIC DISCLOSURE OF CERTAIN QUALIFYING GASIFICATION
PROJECT PROGRAM APPLICATION INFORMATION
|
| In the event that the Application for § 48B Certification
of [(Insert name of applicant-taxpayer here): ] (the
Applicant-Taxpayer) for an allocation of qualifying gasification project credits
under section 48B of the Internal Revenue Code is approved, the undersigned
authorized representative of the Applicant-Taxpayer hereby consents to the
disclosure by the Internal Revenue Service through publication of a Notice
in the Internal Revenue Bulletin or a press release of: (1) the name of the
Applicant-Taxpayer; (2) if the Applicant-Taxpayer is a member of an affiliated
group filing consolidated returns, the name of the common parent of the group;
(3) the type and location of the project that is the subject of the Application
for § 48B Certification; and (4) the amount of the allocation, if
any, of qualifying gasification project credits for such project. The undersigned
understands that this information might be published, broadcast, discussed,
or otherwise disseminated in the public record.
|
| This authorization shall become effective upon the execution thereof.
Except to the extent disclosure is authorized herein, the returns and return
information of the undersigned taxpayer are confidential and are protected
by law under the Internal Revenue Code.
|
| I certify that I have the authority to execute this consent to disclose
on behalf of the taxpayer named below.
|
| Date: |
| Signature: |
| Print name: |
| Title: |
| Name of Applicant-Taxpayer: |
| Taxpayer Identification Number: |
| Taxpayer’s Address: |
| |
| Note: Treasury Regulations require that the Internal Revenue Service
must receive this consent within 60 days after it is signed and dated.
|
