F-CDM-CPAR

Component project activity inclusion review form
(Version 01.0)
Section 1: General information
Name of designated national authority/Executive Board member submitting this form:
Reference number of the CDM Programme of activities (PoA):
Title of PoA:
Reference number of the Component Project Activity (CPA) the inclusion of which is requested to be reviewed:
Section 2: Basis for review request
Please indicate the issues associated with the compliance of the CPA with the eligibility criteria specified in the PoA-DD for which you have reasonable concern about whether they would disqualify the proposed CPA from inclusion in the PoA or renewal of its crediting period. Check the appropriate box and specify the relevant criterium (criteria) in the list below and the corresponding paragraph(s) of the PoA.
The following are the issues that elegibility criteria shall cover according to the Standard for Demonstration of additionality, development of eligibility criteria and application of multiple methodologies for programme of activities.
(a) The geographical boundary of the CPA including any time-induced boundary consistent with the geographical boundary set in the PoA;
Please specify paragraph(s) of PoA-DD
(b) Conditions that avoid double counting of emission reductions like unique identifications of product and end-user locations (e.g. programme logo);
Please specify paragraph(s) of PoA-DD
(c) The specifications of technology/measure including the level and type of service, performance specifications including compliance with testing/certifications;
Please specify paragraph(s) of PoA-DD
(d) Conditions to check the start date of the CPA through documentary evidence;
Please specify paragraph(s) of PoA-DD
(e) Conditions that ensure compliance with applicability and other requirements of single or multiple methodologies applied by CPAs;
Please specify paragraph(s) of PoA-DD
(f) The conditions that ensure that CPAs meet the requirements pertaining to the demonstration of additionality;
Please specify paragraph(s) of PoA-DD
(g) The PoA-specific requirements stipulated by the CME including any conditions related to undertaking local stakeholder consultations and environmental impact analysis;
Please specify paragraph(s) of PoA-DD
(h) Conditions to provide an affirmation that funding from Annex I parties, if any, does not result in a diversion of official development assistance;
Please specify paragraph(s) of PoA-DD
(i) Where applicable, target group (e.g. domestic/commercial/industrial, rural/urban, grid-connected/off-grid) and distribution mechanisms (e.g. direct installation);
Please specify paragraph(s) of PoA-DD
(j) Where applicable, the conditions related to sampling requirements for a PoA in accordance with the approved guidelines/standard from the Board pertaining to sampling and surveys;
Please specify paragraph(s) of PoA-DD
(k) Where applicable, the conditions that ensure that every CPA in aggregate meets the small-scale or microscale threshold criteria and remains within those thresholds throughout the crediting period of the CPA;
Please specify paragraph(s) of PoA-DD
(l) Where applicable, the requirements for the debundling check, in case CPAs belong to small-scale (SSC) or microscale project categories;
Please specify paragraph(s) of PoA-DD
(m) Other issues.
Please specify paragraph(s) of PoA-DD
Please provide reasons in support of the request for review and list the titles of any supporting documentation that you are submitting with this request.
Section below to be filled in by UNFCCC secretariat
Date received at UNFCCC secretariat:

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History of the document

Version / Date / Nature of revision(s)
01.0 / EB 66
13 March 2012 / Initial publication.
Decision Class: Regulatory
Document Type: Form
Business Function: Registration

Version 01.0 Page 3 of 3