Follow the steps to successfully fill out the form.

1. Click the ‘Get Form’ button to access the document and open it in your preferred format.
2. Begin by filling out the property information section. Include the property name, its legal description (quarter sections, township, range), address, city, state, ZIP code, and parcel number. Ensure that you provide accurate details regarding the property size in acres and any applicable x/y coordinates.
3. Enter the lender information by providing the organization name, title of the contact person, their full name, telephone number, address, city, state, ZIP code, and email address.
4. Complete the previous landowner information section. Fill in the organization, title, name, telephone number, address, city, state, ZIP code, and email address (optional) of the previous owner prior to the lender's acquisition.
5. In the environmental consultant section, provide similar details as above for the individual representing the lender, ensuring to include their organization, title, telephone number, address, and email address (optional).
6. Next, complete the attorney representing the lender field with the same level of detail as the previous sections. Ensure accuracy in the name, title, organization, contact number, and address.
7. Proceed to the regulatory criteria section. Answer 'Yes' or 'No' to the relevant questions about hazardous substances detected, whether contamination has been reported to the state, and details regarding petroleum contamination or leaks.
8. You will need to detail when you acquired the property and confirm whether you have legal title. Specify the method for enforcing your security interest and acquiring the title while providing any applicable statutory provisions.
9. List all technical reports related to environmental assessments at the site, including the report titles, completion dates, and submission dates to the DNR.
10. Finally, review the certification section. Type or print your name, sign, and provide your title and the date to confirm that you are authorized to submit this information on behalf of the lender.
11. Once completed, save the changes to the document. You can then download, print, or share the form as needed.

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