Form C - Applicant Disclosure - Livestock
This information is provided by the Nebraska Department of Environment and Energy to assist the public and regulated community.
Form #: WAT022 Applications and Forms Revised: 6/1/11
SizeFile Name
109 KB Form C - Disclosure.pdf

This Applicant Disclosure is required by all applicants for livestock waste control facilities (LWCF) construction approvals, concentrated animal feeding operation permits, requests for coverage under a general permit, major modifications, or requests for permit transfers. If additional space is needed for any section, please print, “See Attached,” and attach the information on a separate sheet of paper

Note: Effective Oct. 1, 2009, any individual submitting any application or form that would derive public benefit from the state must also fill out a United States Citizenship Attestation form. This applies to individuals submitting the forms on their own behalf. If applicable, please fill out the United States Citizenship Attestation form below and submit it with the relevant applications and forms.

United States Citizenship Attestation Form

This Complete Form is only available as an Adobe Acrobat (PDF) file.
File size is 97 KB