Privacy Notice Statement

Your personal information is being collected to process your request to the Participant Funding Program (PFP) pursuant to the National Energy Board Act. Providing this information is voluntary however, missing information may affect our ability to communicate with you and assess your application. Your personal information will be protected in accordance with the Privacy Act. You have the right to access and correct any of your personal information held by the NEB. For more details contact the NEB's Access to Information and Privacy Coordinator at and cite Personal Information Bank NEB PPU 025.

Applicant(legal entity or individual applying for funding)

Funding Opportunity / Environmental Assessment of the Manitoba-Minnesota Transmission Project
Name
Mailing address
Telephone Number
Fax Number
Email
CRA Business # or Band #
Primary Contact (person the NEB will contact about this application) / Same as Applicant
Name and Title
Mailing address
Telephone Number
Fax Number
Email
Preferred language of correspondence: / English / French
Authorized Representative (person authorized to sign the PFP agreement and related claims) / Same as Primary Contact
Name and Title
Mailing address
Telephone Number
Fax Number
Email
Preferred language of correspondence: / English / French

1. Check the type that best describes you (funding applicant):

Indigenous group or band e.g. First Nations, Métis, or Inuit
Individual e.g. landowner, individual living on or near the proposed project area
Group of Individuals i.e. unincorporated non-industry not-for-profit group or association
Incorporated non-industry not-for-profit organization

2.Check one or more of the statements below that describe your interest in the proposed project:

I have a direct, local interest in the project, such as living or owning property near the project area.
I have local community insights and/or Aboriginal traditional knowledge about the proposed project.
I have an interest in potential project impacts on treaty lands, settlement lands or traditional territories and/or related claims and rights.
I plan to provide expert information that is relevant to the mandate of the NEB and the proposed project.

Please specifyhow you meet the criteria for each interest you have identified:

3. Briefly describe whose views you represent and the unique information you wish to contribute through your participation in the NEB process that would not otherwise be available or known.

Note: You may be asked to provide a signed resolution (corporate or Band Council) or document authorizing the Applicant to act on behalf of their organization or group if PFP requires further clarity.

4. Will you be sharing costs with any other individual(s) or group(s) in order to maximize the use of the resources?

Funding can be used towards eligible costs to participate in the NEB’s environmental assessment for the following activities:

  • reviewing the Environmental Impact Statement and/or Environmental Assessment
  • preparing and submitting comments to the NEB.

Please note that no financial support will be directed toward:

  • Activities that do not relate to your participation in the NEB’s environmental assessment e.g. negotiations with the proponent, issues outside the NEB's jurisdiction.
  • Services, studies or written materials that duplicate information prepared by you (e.g. for the provincial environmental assessment by the Manitoba Clean Environment Commission), the NEB, the proponent, or other public sources.
  • Costs not directly incurred e.g. applicant wants to pay him or herself, lost income, facility or rental equipment owned by applicant, general administration fee.
  • Duplicative payments e.g. costs reimbursed by other funding arrangements, individuals already in receipt of income for their time.
  • Normal operating expenses such as rent, overhead, general operations, or salaries.
  • Capital expenditures, costs for construction, renovation of buildings and maintenance.

5. Please complete the following table summarizing your funding request by eligible cost type. Provide sufficient detail on costing and purpose for PFP to assess reasonableness and eligibility of costs. You can provide additional details in a separate document as needed.Feel free to add or remove rows as needed.

  • Cost Description: Name provider if known and explain why each cost is required in support of your planned participationin the NEB process.
  • For staff, also specify if individual is already in receipt of income for this work e.g. salary, other source of funds.
  • For travel, also specify why teleconference or other remote meeting solutions is not possible.
  • Cost Details: show how you calculated the cost (e.g. daily or hourly rate and amount of time required) or reference the supporting document which provides the calculation. For travel, see thefederal travel directive’sAppendix B - Kilometric Rates and Appendix C - Allowances for rates.
  • Funding Requested: specify the amount of PFP funding (tax included).

Eligible Cost Type / Cost Description / Cost Details / Funding Requested
Legal Services
Expert Services
Staff
Travel and Meeting expenses
Honoraria for elders and ceremonial costs
Collection, distribution, translation or purchase of information
(A) Total Cost
(B) Enter applicable Funding Maximum
individual $12,000 or group $80,000
Total Requested Funding = lesser of A or B

6. Will you be receiving any other sources of funding for the same costs for which you have requested participant funding above?

Yes / No

If yes, please specify the amount, purpose and source of the funding:

7. Is the funding applicant a former federal public servant who is required to abide by the Policy on ConflictofInterestandPost-employment?

Yes / No

If yes, please explain:

Certification and consent

I hereby certify that the information provided in this Funding Application is true, accurate and complete. I understand that if any information provided is false or misleading, the Applicant may be denied funding or may be required to reimburse all or part of funding received. I understand that if the NEB awards funds, the Applicant must sign a contribution agreement and claim for expenses incurred before any funding is provided. I understand that the information provided will be used to administer funding in accordance with the NEB's PFP program, including public disclosure of any award. I understand that funding is conditional on participating in the NEB process.

Name and Title Date

IMPORTANT

Before sending in your application, make sure it is complete. For assistance, read the PFP Guideorcontact the PFP at 1-800- 899-1265 or

Send your form to PFP by the deadline. You can send in your application by:

  • Email to
  • mail or courier to:

National Energy Board

Attn: Participant Funding Program

Suite 210, 517 Tenth Avenue SW

Calgary, Alberta T2R 0A8

  • or by fax at 1-877-288-8803

FEEDBACK

Your feedback will help the NEB evaluate and improve the participant funding program. Your responses will not impact funding decisions in any way. For each question, please select the response that best describes your experience.

a) I first learned about the participant funding available for this proposed project through:

NEB Website
NEB info session or open house
Media (newspaper, radio, tv)
Company proposing project under review (proponent)
Consultant or legal firm
Other, please specify:

b) I found this application form understandable and easy to fill out.

Agree / Somewhat agree / Neutral / Somewhat disagree / Disagree

c) I required help to complete this application form.

No / Yes, from NEB / Yes, from hired professional e.g. legal

b) I found PFP staff responded to my questions in a respectful and timely manner.

Agree / Somewhat agree / Neutral / Somewhat disagree / Disagree

e) Please provide any suggestions you may have to improve this application form or the funding process:

Page 1