CDM-CCS-EOA-FORM CDM: Form for Expression of Agreement for carbon dioxide capture and storage (CCS) project activities by DNAs (Version 01.0) (To be used by DNAs for submitting expression of agreement for CCS project activities) Host Party: Name and title of the representative of the DNA: authorized Address: Contact information: Tel: Email: Signature of the authorized representative of host Party: Date: Information for completing the form The information in square brackets should be completed as appropriate. Expression of Agreement (EOA) for CCS project activities >> [[Designated national authority] on behalf of [host Party]] confirms that: 1. [The [host Party] agrees to allow the implementation of CDM carbon capture and storage (CCS) project activities on its territory; and 2. [The [host Party]] has established laws or regulations in accordance with the modalities and procedures for carbon dioxide capture and storage in geological formations as clean development mechanism project activities (decision 10/CMP.7) . Version 01.0 Page 1 of 3 CDM-CCS-EOA-FORM Appendix – applicable host Party laws and regulations (Host Party is encouraged to fill this appendix , increase the number of rows wherever required) >> The following host Party laws or regulations fulfill the requirements set out in ‘Laws and regulations of host Party for CCS project activities’ section of the Project cycle procedure: 1. Selection and characterization of geological storage site Name of law(s) and/or regulation(s) Effective date 2. Rights to store carbon dioxide Name of law(s) and/or regulation(s) Effective date 3. Timely and effective redress for any damages Name of law(s) and/or regulation(s) Effective date 4. Time and effective remedial measures to stop or control any unintended seepage of carbon dioxide Name of law(s) and/or regulation(s) Effective date 5. Liability for storage sites Name of law(s) and/or regulation(s) Effective date 6. Obligation to net reversal of storage where applicable Name of law(s) and/or regulation(s) / Effective date agreements(s) INFORMATION TO BE COMPLETED BY THE UNFCCC SECRETARIAT DNA-Submission number Date when the communication was received by the secretariat ----Version 01.0 Page 2 of 3 CDM-CCS-EOA-FORM Document information Version Date Description 01.0 4 April 2014 EB 78, Annex 7 Initial adoption. Decision Class: Regulatory Document Type: Form Business Function: Registration Keywords: DNA, carbon capture and storage, expression of agreement Version 01.0 Page 3 of 3