ARSD 74:32:03:01. Application for reimbursement

Upon receiving notice of a spill or release, the director shall send application forms to the covered party. The application forms must be signed by the covered party or an agent of the covered party and contain the following information: (1) The name, address, and telephone number of the covered party; (2) The name, address, and telephone number of the contact person; (3) The name and address of the operator; (4) The street or highway description of the petroleum release location; (5) The legal description of the release location; (6) The motor fuel dealer or special fuel distributor tax number; (7) The substance released; (8) The date the spill or release was discovered; (9) A complete narrative description of the spill or release; (10) A completed subrogation assignment as provided by the director and signed by the covered party or the agent of the covered party; and (11) A completed form W-9 from the United States Internal Revenue Service signed by the covered party or the agent of the covered party. Reimbursement from the fund may not be made unless a complete application is returned to the director. The covered party shall certify to the truthfulness of all information on the application.