Annex III of Resolution 294/01 – Simplified Application for Palmetto (Euterpe Edulis) Exploitation

His/hers Excellence Mr./Mrs./Ms. State Superintendent of the Brazilian Institute for the Environment and Renewable Natural Resources – IBAMA/SC, , the undersigned, residing at ___________________District of ,__________________ Municipality of _________, State____ nacionality________________, profession_____________, Civil state___________, CPF number__________ ID/Issued By/State ______________________________ hereby requests from Your Excellence a License for the Exploitation of the Palmito (Euterpe edulis), which will be carried out within his/her property in accordance with the provisions foreseen by Resolution 294/01, art. 5, single paragraph and with the specifications stated hereunder:

1 Property location;
2 Property area (ha);
3 Area covered by natural forest (ha );
4 Selective logging/cutting area (ha);
5 Area allocated for Legal Reserve (ha);
6 Volume (number of heads) of palmito that will be exploited;
7 Identification data on the Responsible professional (name, full address, CGC or CPF, profession, IBAMA registration number, registration number in the competent professional council and visa number/region, if applicable); and
8 Survey and authorization by the competent licensing organ, including assessment of criteria specified in articles 3 and 5 of this Resolution.

The following documentation has been added in order to complete the required information:
a) actualized property deed;
b) proof of payment of Rural Territorial Tax (ITR) for the previous year;
c) sketch of the property;
d) sketch of access roads to the property in relation to the municipality where the same is located;

Delimitation of the Legal Reserve Area: ________________________________

Signs the present Application in three equal content and form copies in the presence of the IBAMA Superintendent and of the witnesses named hereunder who also sign three copies of the topographic map.

IBAMA Superintendent