Get Karb Application Form

Filling out the Karb Application Form online can streamline the process of applying for reimbursement. This guide provides clear and detailed instructions to assist users in completing each section accurately and efficiently.

Follow the steps to complete your application successfully.

1. Press the ‘Get Form’ button to access and open the Karb Application Form in the appropriate online editor.
2. Indicate the type of application by checking either 'Initial Request' or 'Subsequent Request' in the General Information section. Enter the KDHE Site ID # if you have one, and attach the KDHE Order or Approval Letter if applicable.
3. In the Applicant / Eligible Person section, specify whether the applicant is the owner, operator, or another party. Enter the company name and mailing address, along with the individual's name, title, telephone number, fax number, Social Security number (if applicable), Kansas tax ID, and ZIP code.
4. Provide contact information and site identification by filling in the incident site name, the contact person at the incident site, their phone number, the incident site location, and county.
5. Detail the remediation activities by entering the dates of invoices submitted with the application and a brief chronological description of these activities. Attach additional sheets if necessary for more space.
6. In the Discharge Site Information section, select the qualifying activities that environmental assessments were paid for and include any required maps or documentation. Indicate if there has been previous reimbursement from KARB and whether any other agency is being applied to for reimbursement.
7. List any other individuals involved in incurring corrective action costs, if applicable. Provide their names, addresses, and relationships to the eligible person.
8. Fill out the Contractors / Consultants section with the names and contact information of all contractors or consultants who performed corrective actions. Describe the financial relationship if applicable.
9. Complete the Eligible Costs Summary (ECS) section by reporting actual incurred costs. Use the accompanying Cost Detail Worksheets to itemize costs and ensure totals are correctly transferred to the ECS Table.
10. Identify other financing sources and complete the necessary details, including any insurance policies related to the incident and claims filed.
11. Review and certify the application by signing and dating where required. Ensure that all information is true and accurate to the best of your knowledge.
12. Once all fields are completed, save your changes. You can download, print, or share the form as needed to complete the submission process.

Take action today and complete your Karb Application Form online for efficient processing.