Financial Responsibility Forms For use by Solid Waste Landfills

The Bureau of Waste & Materials Management is in the processing of converting all of our Solid Waste Financial Responsibility Forms to fillable forms. You will be able to fill out the form electronically, then print and submit it. Currently, only the letter of credit forms are available in the fillable version, and are posted below. As each form is converted to a fillable version, they will be posted here. We hope to complete the conversion of all forms within the next few months.

• Long-Term Care Performance Bond - Fillable
  • FORM 4400-64
  • File Name: 4400-64SW.pdf
  • Size: 50KB
    
• Closure Performance Bond - Fillable
  • FORM 4400-65
  • File Name: 4400-65SW.pdf
  • Size: 44KB
    
• Long-Term Care Irrevocable Trust Agreement
  • FORM 4400-69
  • File Name: 4400-69SW.pdf
  • Size: 22.22KB
    
• Closure Irrevocable Trust Agreement
  • FORM 4400-68
  • File Name: 4400-68SW.pdf
  • Size: 22.33KB
    
• Long-Term Care Irrevocable Escrow Agreement
  • FORM 4400-71
  • File Name: 4400-71SW.pdf
  • Size: 22.81KB
    
• Closure Irrevocable Escrow Agreement
  • FORM 4400-72
  • File Name: 4400-72SW.pdf
  • Size: 22.38KB
    
• Long-Term Care Irrevocable Letter of Credit - Fillable
  • FORM 4400-080 Revised 08/05
  • File Name: 4400-080_fillPrint.pdf
  • Size: 56KB
    
• Closure Irrevocable Letter of Credit - Fillable
  • FORM 4400-81 Revised 08/05
  • File Name: 4400-081_fillPrint.pdf
  • Size: 55KB
    
• Closure Performance Bond - Solid Waste Treatment/Storage Facilities
• FORM 4400-192
• File Name: 4400-192SW.pdf
• Size: 35KB
  
Last Revised: Wednesday June 25 2008