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Reporting Template for Disclosure of Areas Cleared without Prior HCV Assessment since November 2005

Date of submission
Reporting Guidance

DD/MM/YYYY

1. COMPANY INFORMATION
Box 1.1 - Name of RPSO member
Box 1.2 - RSPO membership number
Box 1.3 - Date of joining RSPO
Box 1.4- Date of first RSPO certification

DD/MM/YYYY

Box 1.5 - Total number of certified management units


Separate reports should be filed for each management
unit

Box 1.6- Name of subsidiary/management unit

Additional location details to be supplied in supporting


documents

Box 1.7 - Country of subsidiary/management unit


Box 1.8 - Province and district of
subsidiary/management unit

2. SUMMARY OF RAW LIABILITY

Please describe whether or not there has been any


liability to report for this management unit due to
clearance since 2005 without prior HCV asssessment.
If there is no liability to report, leave Boxes 2.22.9 blank.

Box 2.1 - For this management unit, is there any


liablity to report due clearance without prior
HCV assessment?
Y/N

What was the nature of the liability? (E.g. land clearing


without prior HCV assessment)

Box 2.2 - Description of liability

Period of liability begins at the November 2005 cutoff


date through the date at which liability was resolved.
In most cases, the end of the liabilityperiod would be
date of completion of the HCV assessment.

Description of how the liability was resolved (e.g. HCV


assessment completed).

For the full time period of liability, was the


management unit under control of a non-RSPO
member, an RSPO member with no certified
management units at the time of liability, or an RSPO
member with certified management unit(s) at the time
of liability. Please explain any changes in control that
occured during the time period of liability.

Box 2.3 - Period of liability

11/2005-DD/MM/YYYY

Box 2.4 - Briefly explain resolution of liability

Box 2.5 - Controlling party of management unit during


time period of liability

Box 2.6 - Starting date of management control of unit


by reporting company
Box 2.7 - Total area of management unit (hectares)
Total area cleared during time period of liability.This is
the total area cleared without prior HCV assessment.

Box 2.8- Total area of raw liability (hectares)


Box 2.9 - Sub-totals of raw liability, by timeframe (in
hectares)
Time of clearance

Hectares of raw liability (e.g. hectares cleared without


prior HCV assessment) , divided into the timeframes
provided based on when the clearing occured. Only
report areas cleared until the end date of the time
period of liability (do nto report clearing that occured November 2005 to 30 November 2007
after HCV assessment).

Potential loss of HCV 4-6 shall be assessed, either


through existing evidence or a new process. Section 9
and Annex 1 of the Remediation and Compensation
Procedures provides additional details.

v0-140120-ort_x000D_page with guidance

December 1, 2007-December 31, January 1, 2010 - May 9, 2014 (date of introduction Land clearing after May 9, 2014 (date of
2009
of compensation mechanism)
introduction of comp mechanism)

Box 2.10 - Any potential Social Impacts related to


losses of HCVs 4,5,or 6?

Y/N

Box 2.11 - Briefly explain specific circumstances?+B51

DRAFT ONLY_x000D_FOR COMMENTS

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