Renewable Energy Sourcing Declaration Form
Organization Name
Contact Person
Email Address
Phone Number
Organization Address
Renewable Energy Details
Solar
Wind
Hydro
Biomass
Other
Describe Renewable Energy Source(s)
Percentage of Energy from Renewable Sources (%)
Name of Energy Supplier(s)
Renewable Energy Sourcing Start Date
Renewable Certification (if any)
Additional Information / Comments
Authorized Signatory Name
Date