Application

I certify that the named applicant is a domestic entity as defined below and is not owned by, controlled by, or subject to the jurisdiction or direction of a government of a Country of Risk and meets the eligibility requirements for this program. I further represent that the information contained in the submission is true and contains no misrepresentations. I understand that any false, fictitious, or fraudulent information, misrepresentations, half-truths, or omissions of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. (18 U.S.C. §§ 1001 and 287, and 31 U.S.C. 3729-3733 and 3801-3812). I further understand and agree that the statements and representations made herein are material to Department of Energy's (DOE) funding decision.

Note: To qualify as a domestic entity, the entity must be organized, chartered or incorporated (or otherwise formed) under the laws of a particular state or territory of the United States; have majority domestic ownership and control; and have a physical place of business in the United States.