PCS SF 002 Sustainable Development Impact Assessment Form_v1.0

Document Control

Document identification

• Document code: PCS-SF-002

• Title: Sustainable Development Impact Assessment Form

• Scope: Used by Project Developers to assess and report measurable contributions to the UN Sustainable Development Goals (SDGs) and related co-benefits, and to support SDG disclosure and dashboards under PCS rules.

Version history and change log

Table DC-1. Revision history

Version	Date	Status	Summary of changes	Prepared by	Approved by
v1.0	TBD	Draft	Release for public consultation	PCS	TBD

Superseded versions

No superseded versions for v1.0.

Governance note on versioning and archiving

Only the latest approved version of this form shall be used. Superseded versions shall be archived and retained for traceability and audit purposes. Printed or downloaded copies are uncontrolled; the PCS published version is the authoritative current version.

Purpose

This form is used by Project Developers to assess and report project contributions to the United Nations Sustainable Development Goals (SDGs). The purpose of this form is to demonstrate measurable social, environmental, and economic co-benefits beyond carbon impact.

Section A – Basic Project Information

PCS Project ID
Project Title
Project Category	☑ Nature-Based Solutions (NBS) – Project Type C
Host Country
Project Developer / Organization

Section B – SDGs Selected for Project Contribution

Tick the SDGs that the project contributes to. For each selected goal, complete the assessment in Section C.

SDG No.	Sustainable Development Goal	Selected (☑)
1	No Poverty	☐
2	Zero Hunger	☐
3	Good Health and Well-being	☐
4	Quality Education	☐
5	Gender Equality	☐
6	Clean Water and Sanitation	☐
7	Affordable and Clean Energy	☐
8	Decent Work and Economic Growth	☐
9	Industry, Innovation, and Infrastructure	☐
10	Reduced Inequalities	☐
11	Sustainable Cities and Communities	☐
12	Responsible Consumption and Production	☐
13	Climate Action	☐
14	Life Below Water	☐
15	Life on Land	☐
16	Peace, Justice, and Strong Institutions	☐
17	Partnerships for the Goals	☐

Section C – Impact Assessment for Selected SDGs

For each SDG selected in Section B, provide details on how the project contributes to the goal, including qualitative and quantitative indicators, methods of verification, and data sources.

SDG No.	Type of Impact	Description of Contribution	Verification Method / Evidence	Expected Outcome / Target

Section D – Quantitative Indicators & Measurement

List measurable indicators for selected SDGs. Include baseline, target, unit, frequency of monitoring, and data source.

SDG No.	Indicator Description	Baseline Value	Target Value	Unit of Measurement	Data Source / Frequency

Section E – Co-benefits Summary

Summarize the project’s broader co-benefits across environmental, social, and economic dimensions. Where possible, link them to quantified SDG contributions reported in the Monitoring Report.

Environmental Co-benefits
Social Co-benefits
Economic Co-benefits
Cross-cutting Impacts (if any)

Section F – Declaration and Digital Signature

By submitting this form, the Project Owner/Developer confirms that all SDG impact information is accurate, that the indicators have been verified, and that supporting evidence is retained in project documentation. All information will be published in the PCS SDG Dashboard following approval.

Authorized Representative (Name)
Organization
Digital Signature / Blockchain Verification Hash