Download Proposed special underdeveloped zone submission - CDM

CDM-SUZ-FORM
Proposed special underdeveloped zone submission form
(Version 01.0)
Submitting DNA:
Contact Information:
(name of person or office, e-mail addresses and
phone contacts)
Signature, and stamp of the authorized signatory
of the DNA:
Date of submission:
IDENTIFICATION OF THE SPECIAL UNDERDEVELOPED ZONE
Name and geographical coordinates of the region
proposed as special underdeveloped zone (SUZ):
Attach map indicating the region proposed as
SUZ:
Attach official notifications for development
assistance by the host country in which the
region proposed as SUZ has been identified:
INFORMATION TO BE ATTACHED (fill (a) and/or (b))
(a) The proportion of the population of the
proposed SUZ with income less than
USD 2 per day (PPP adjusted) is greater
than 50%:
Yes
No
If yes:
Public available data on the proportion of
population of the region proposed as SUZ with
income less than USD 2 per day (PPP) are
attached.
The source of the data is provided.
(b) The Gross National Income (GNI) per capita
of the country is less than USD 3000 and the
population of the region is among the
poorest 20% in the poverty ranking of
the host country:
Yes
No
If yes:
Public available data on the GNI of the host
country are attached.
Public available data on the poverty ranking
within the host country are attached.
Information to conclude that the population of
the region proposed as SUZ is among the
poorest 20% in the poverty ranking of the host
country is attached.
Version 01.0
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CDM-SUZ-FORM
The sources of the data are provided.
FURTHER INFORMATION
Any additional information or data and their
sources you consider relevant to identify the
proposed SUZ:
SECTION BELOW TO BE FILLED IN BY UNFCCC SECRETARIAT
Submission number:
Date when the form was received by
UNFCCC Secretariat:
----Document information
Version
Date
Description
01.0
26 November 2012
Initial publication.
Decision Class: Regulatory
Document Type: Form
Business Function: Methodology
Keywords: special underdeveloped zones, additionality
Version 01.0
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