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Business Concern Disclosure Form - Ohio
| Business Concern Disclosure Form Form. This is a Ohio form and can be used in Citizen Protection Attorney General Office Statewide . |
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BUSINESS CONCERN DISCLOSURE FORM (PRIVATE AND GOVERNMENT ENTITIES) For each business concern which is an applicant for or holder of a solid waste, or infectious waste, or hazardous waste permit, and prospective owners of an off-site facility and for each business concern which is a partner of such applicant, or permittee, or prospective owner, and for each business concern which owns or controls the applicant, permittee, or prospective owner. Also, for a government entity which is the applicant, permittee, or prospective owner of the subject facility, that government entity must answer Questions 11 through 16 and Question 21 on this form. The government entity should also complete the questions on pages 1 and 2 located prior to Question 1, of this form. Pursuant to R.C. 3734.40-3734.47 and O.A.C. Sections 109:6-1-01 through 109:6-1-05 American LegalNet, Inc. www.FormsWorkflow.com BUSINESS CONCERN DISCLOSURE FORM 1. WHO MUST COMPLETE THIS FORM. Each business concern which is an applicant for, or holder of, a solid waste infectious waste, or hazardous waste permit, and prospective owners of an off-site facility and for each business concern which is a partner of such applicant, or permittee, or prospective owner, and for each business concern which owns or controls such applicant, permittee, or prospective owner, must complete this forms. Sole proprietors must complete this form and an Annual Maintenance Update/New Call-In/Personal History Disclosure Form. Also, a government entity, which is the applicant, permittee, or prospective owner of the subject facility, must answer Questions 11 through 16 and Question 21 on this form. ALL QUESTIONS MUST BE ANSWERED. Read every question carefully before answering any. Answer every question completely. Do not leave any blank spaces. If a question does not apply to you, enter "Not applicable" or "N/A" in the space provided for an answer. If there is nothing to disclose in answer to a particular question, enter "None" in the space provided for an answer. ANSWER COMPLETELY AND TRUTHFULLY. Failure to answer any questions completely may result in your statement being returned to you for supplementation of your answer. If the answer to a question in this form is identical to an answer previously given to a question in the form, you may answer the later question by writing "Same as ." For example, if the answer to Question 3 is the same as the answer to Question 2, you may answer Question 3 by writing "Same as 2". WARNING: FRAUDULENT, DECEPTIVE OR MISLEADING ANSWERS MAY RESULT IN THE DENIAL OR REVOCATION OF YOUR LICENSE. IN ADDITION, ANY PERSON WHO KNOWINGLY OR RECKLESSLY MAKES FALSE OR MISLEADING STATEMENTS ON THIS FORM MAY BE SUBJECT TO CRIMINAL PROSECUTION. Be especially careful not to omit information in a way that might create an impression that you are trying to hide it. For example, a minor criminal conviction will probably not disqualify your firm from being licensed but attempting to conceal the conviction may lead to a finding of untrustworthiness, and result in disqualification. Omitting such information from this form, even unintentionally, may result in your trustworthiness being questioned. Even if the question is resolved in your favor, your application may be delayed while the inquiry goes forward. If you are unsure of, or do not remember the answer to a question, indicate this in some way for example, by writing "Do not remember." This may result in additional inquiries from the Director of the OEPA or the Attorney General's Office, but it will avoid implication that you are trying to conceal information. However, you should not answer "Do not remember," or with similar words, simply because the information may not be immediately at hand. You are expected to make reasonable efforts to check your records so that you can answer the questions completely. 2. 3. American LegalNet, Inc. www.FormsWorkflow.com 4. ADDITIONAL SPACE. If you need additional space to answer a question, use plain 8 ½" x 11" paper. Insert additional pages immediately following the page on which the question you are answering appears. Be sure to indicate that your answer to the question is "continued on next Page," and indicate on the additional page which question is being continued there. When you have finished answering all questions, and have attached all additional pages, consecutively number each page at the top right corner including the additional pages. Pages of the original form, which need to be renumbered as a result of adding pages, should be renumbered at the space provided after "Your Page No. ." 5. EXHIBITS. If you are required or wish to submit any document in connection with your answer to any question, refer to it in your answer as, for example, "Exhibit No.," and attach it at the end of the form. TYPE OR PRINT YOUR ANSWERS. Type or print in legible block letter style. Handwritten forms will be returned if entries are in script or are unreadable. DO NOT USE A SCRIPT TYPEFACE. INTERPRETIVE ASSISTANCE IN COMPLETING DISCLOSURE STATEMENTS. If an applicant, permittee, or prospective owner needs interpretive assistance in completing a disclosure statement, you may submit in writing to the Attorney General a regulatory guidance request seeking an informal, non -binding interpretation of a regulatory requirement imposed by sections 3734.40 to 3734.47 of the Ohio Revised Code and the rules adopted thereunder. a. The submission of a regulatory guidance request shall in no way alter the obligation of an applicant, permittee or prospective owner to fully comply with all requirements imposed by sections 3734.40 to 3734.47 of the Ohio Revised Code and the Ohio Administrative Rules adopted thereunder. b. The Attorney General is under no obligation to respond to a regulatory guidance request other than as the Attorney General determines in his or her sole discretion, based upon available human resources and the need to employ those resources to perform the mandatory obligations imposed by Sections 3734.40 of the Ohio Revised Code and the rules adopted thereunder. c. The response provided by the Attorney General to any regulatory guidance request shall be used by the applicant, permittee, or prospective owner solely as a guidance to assist in the preparation of a disclosure statement. The response of the Attorney General shall not be binding upon anyone, including, but not limited to, the applicant, permittee or prospective owner, the Attorney General,
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