Form EPA Form 7610-5 (R EPA Form 7610-5 (R General Account Form

Instructions for General
Account Form
The Acid Rain Program CAIR Trading Programs (CAIR NOX Annual, CAIR SO2, and CAIR NOX Ozone
Season), and Transport Rule Programs (TRNOx Annual, TRNOx Ozone Season, TRSO2 Group 1, and TRSO2
Group 2) regulations require any person, company, or organization wishing to open a general account for the
purpose of holding and transferring allowances to submit a completed General Account form. You also may
use this form to change the information previously submitted for a general account, such as the identity of the
authorized account representative. In such cases, enter your allowance account identification number in the
space provided at the top of the form. Note: A compliance account can only be established, and information
concerning a compliance account can only be changed, by submitting a Certificate of Representation form.
If you need assistance, call the Clean Air Markets Hotline at 202-343-9620.
STEP 2

The owners may choose an alternate to act on behalf of the Authorized Account Representative.

STEP 3

Identify all parties with an ownership interest in the allowances held in this account. All of these
parties must be subject to a binding agreement authorizing the representation of the account by the
authorized account representative, and, if applicable, the alternate authorized account
representative, identified in Steps 1 and 2. If you (the authorized account representative) are the
only person with an ownership interest in the allowances held in the account, list your name here. If
additional space is needed, please attach a separate sheet of paper.

STEP 4

If you are establishing a general account, both the authorized account representative and the
alternate (if any) must sign and date the certifications. You are encouraged to use the CAMD
Business System (CBS) to submit general account information online. To register for CBS, go to
https://camd.epa.gov/loginrequest/index.cfm.

For more information see the applicable rule:
Acid Rain: 40 CFR 73.31
CAIR NOX Annual: 40 CFR 96.151 or 97.151 or the applicable State rule
CAIR SO2: 40 CFR 96.251 or 97.251 or the applicable State rule
CAIR NOX Ozone Season: 40 CFR 96.351 or 97.351 or the applicable State rule
Transport Rule NOX Annual: 40 CFR 97.420
Transport Rule NOX Ozone Season: 40 CFR 97.520
Transport Rule SO2 Annual: 40 CFR 97.620 or 97.720
Paperwork Burden Estimate
The public reporting and recordkeeping burden for this collection of information is estimated to average 10
hours per response. Burden means the total time, effort, or financial resources expended by persons to
generate, maintain, retain, or disclose or provide information to or for a Federal agency. This includes the
time needed to review instructions; develop, acquire, install, and utilize technology and systems for the
purposes of collecting, validating, and verifying information, processing and maintaining information, and
disclosing and providing information; adjust the existing ways to comply with any previously applicable
instructions and requirements; train personnel to be able to respond to a collection of information; search data
sources; complete and review the collection of information; and transmit or otherwise disclose the information.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number.
Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates,
and any suggested methods for minimizing respondent burden, including through the use of automated
collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency
(2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any
correspondence. Do not send the completed form to this address.

1

United States
Environmental Protection Agency

OMB Nos. 2060-0258, 2060-0570 and 2060-0667
Approval expires 07/31/2014

General Account Form
For more information, see instructions.
This submission is:

New (to open a new general account)
Revised (to revise information on an existing general account)

This account is authorized to hold allowances in these programs:
Acid Rain/CAIR SO2 Trading
CAIR NOX Ozone Season Trading
CAIR NOX Annual Trading
Transport Rule NOx Annual Trading

Transport Rule NOX Ozone Season Trading
Transport Rule SO2 Group I Trading
Transport Rule SO2 Group II Trading

If you are opening a new allowance account, complete all steps in this form. If this is a revised
submission, enter your account # and account name and complete Step 4 to authorize the change of
information. Only the authorized account representative or alternate authorized account representative
can authorize the change.

Account #

Account Name

STEP 1
Enter requested
information for the
authorized account
representative.

Name

Title

Company Name

Mailing Address

Phone Number

Fax Number

E-mail Address

STEP 2
Enter requested
information for the
alternate authorized
account representative
(required only if you
want the general
account to have an
alternate authorized
account representative).

Name

Title

Company Name

Mailing Address

Phone Number

E-mail Address

EPA Form 7610-5 (Revised 8-2011)

Fax Number

STEP 3
Enter the names of all
parties (persons or
companies) subject to
the binding agreement
authorizing your
representation of the
account.

Name

Name

Name

Name

Acid Rain Program
STEP 4
Read the certifications
and sign and date.

I certify that I was selected under the terms of an agreement that is binding on all
persons who have an ownership interest with respect to allowances held in the
Allowance Tracking System account. I certify that I have all necessary authority to
carry out my duties and responsibilities on behalf of the persons with an ownership
interest and that they shall be fully bound by my actions, inactions, or submissions
under 40 CFR Part 73. I am authorized to make this submission on behalf of the
persons with an ownership interest for whom this submission is made.
I certify under penalty of law that I have personally examined, and am familiar with, the
statements and information submitted in this document and all its attachments. Based
on my inquiry of those individuals with primary responsibility for obtaining the
information, I certify that the statements and information are to the best of my
knowledge and belief true, accurate, and complete. I am aware that there are
significant penalties for submitting false statements and information or omitting
material information, including the possibility of fine or imprisonment for violations.
Clean Air Interstate Rule (CAIR) NOX Annual Trading Program
I certify that I was selected as the CAIR authorized account representative or the
alternate CAIR authorized account representative, as applicable, by an agreement that
is binding on all persons who have an ownership interest with respect to CAIR NOX
allowances held in the general account. I certify that I have all the necessary authority
to carry out my duties and responsibilities under the CAIR NOX Annual Trading
Program on behalf of such persons and that each such person shall be fully bound by
my representations, actions, inactions, or submissions and by any order or decision
issued to me by the Administrator or a court regarding the general account.
I am authorized to make this submission on behalf of the persons having an ownership
interest with respect to the CAIR NOX allowances held in the general account. I certify
under penalty of law that I have personally examined, and am familiar with, the
statements and information submitted in this document and all its attachments. Based
on my inquiry of those individuals with primary responsibility for obtaining the
information, I certify that the statements and information are to the best of my
knowledge and belief true, accurate, and complete. I am aware that there are
significant penalties for submitting false statements and information or omitting
required statements and information, including the possibility of fine or imprisonment.
Clean Air Interstate Rule (CAIR) SO2 Trading Program
I certify that I was selected as the CAIR authorized account representative or the
alternate CAIR authorized account representative, as applicable, by an agreement that
is binding on all persons who have an ownership interest with respect to CAIR SO2
allowances held in the general account. I certify that I have all the necessary authority
to carry out my duties and responsibilities under the CAIR SO2 Trading Program on
behalf of such persons and that each such person shall be fully bound by my

EPA Form 7610-5 (Revised 8-2011)

representations, actions, inactions, or submissions and by any order or decision
issued to me by the Administrator or a court regarding the general account.
I am authorized to make this submission on behalf of the persons having an ownership
interest with respect to the CAIR SO2 allowances held in the general account. I certify
under penalty of law that I have personally examined, and am familiar with, the
statements and information submitted in this document and all its attachments. Based
on my inquiry of those individuals with primary responsibility for obtaining the
information, I certify that the statements and information are to the best of my
knowledge and belief true, accurate, and complete. I am aware that there are
significant penalties for submitting false statements and information or omitting
required statements and information, including the possibility of fine or imprisonment.
Clean Air Interstate Rule (CAIR) NOX Ozone Season Trading Program
I certify that I was selected as the CAIR authorized account representative or the alternate
CAIR authorized account representative, as applicable, by an agreement that is binding on
all persons who have an ownership interest with respect to CAIR NOX Ozone Season
allowances held in the general account. I certify that I have all the necessary authority to
carry out my duties and responsibilities under the CAIR NOX Ozone Season Trading
Program on behalf of such persons and that each such person shall be fully bound by my
representations, actions, inactions, or submissions and by any order or decision issued to
me by the Administrator or a court regarding the general account.
I am authorized to make this submission on behalf of the persons having an ownership
interest with respect to the CAIR NOX Ozone Season allowances held in the general
account. I certify under penalty of law that I have personally examined, and am familiar
with, the statements and information submitted in this document and all its attachments.
Based on my inquiry of those individuals with primary responsibility for obtaining the
information, I certify that the statements and information are to the best of my knowledge
and belief true, accurate, and complete. I am aware that there are significant penalties for
submitting false statements and information or omitting required statements and
information, including the possibility of fine or imprisonment.

Transport Rule (TR) NOX Annual Trading Program
I certify that I was selected as the Transport Rule authorized account representative or
the alternate CAIR authorized account representative, as applicable, by an agreement
that is binding on all persons who have an ownership interest with respect to TR NOX
allowances held in the general account. I certify that I have all the necessary authority
to carry out my duties and responsibilities under the TR NOX Annual Trading Program
on behalf of such persons and that each such person shall be fully bound by my
representations, actions, inactions, or submissions and by any order or decision
issued to me by the Administrator or a court regarding the general account.
I am authorized to make this submission on behalf of the persons having an ownership
interest with respect to the TR NOX allowances held in the general account. I certify
under penalty of law that I have personally examined, and am familiar with, the
statements and information submitted in this document and all its attachments. Based
on my inquiry of those individuals with primary responsibility for obtaining the
information, I certify that the statements and information are to the best of my
knowledge and belief true, accurate, and complete. I am aware that there are
significant penalties for submitting false statements and information or omitting
required statements and information, including the possibility of fine or imprisonment.
Transport Rule (TR) NOX Ozone Season Trading Program
I certify that I was selected as the Transport Rule authorized account representative or
the alternate CAIR authorized account representative, as applicable, by an agreement

EPA Form 7610-5 (Revised 8-2011)

that is binding on all persons who have an ownership interest with respect to TR NOX
Ozone Season allowances held in the general account. I certify that I have all the
necessary authority to carry out my duties and responsibilities under the TR NOX
Ozone Season Trading Program on behalf of such persons and that each such person
shall be fully bound by my representations, actions, inactions, or submissions and by
any order or decision issued to me by the Administrator or a court regarding the
general account.
I am authorized to make this submission on behalf of the persons having an ownership
interest with respect to the TR NOX Ozone Season allowances held in the general
account. I certify under penalty of law that I have personally examined, and am familiar
with, the statements and information submitted in this document and all its
attachments. Based on my inquiry of those individuals with primary responsibility for
obtaining the information, I certify that the statements and information are to the best
of my knowledge and belief true, accurate, and complete. I am aware that there are
significant penalties for submitting false statements and information or omitting
required statements and information, including the possibility of fine or imprisonment.
Transport Rule (TR) SO2 Trading Program Group I
I certify that I was selected as the Transport Rule authorized account representative or
the alternate TR authorized account representative, as applicable, by an agreement
that is binding on all persons who have an ownership interest with respect to TRSO2
Group I SO2 allowances held in the general account. I certify that I have all the
necessary authority to carry out my duties and responsibilities under the TRSO2 Group
I SO2 Trading Program on behalf of such persons and that each such person shall be
fully bound by my representations, actions, inactions, or submissions and by any order or
decision issued to me by the Administrator or a court regarding the general account.
I am authorized to make this submission on behalf of the persons having an ownership
interest with respect to the TRSO2 Group I SO2 allowances held in the general account. I
certify under penalty of law that I have personally examined, and am familiar with, the
statements and information submitted in this document and all its attachments. Based on
my inquiry of those individuals with primary responsibility for obtaining the information, I
certify that the statements and information are to the best of my knowledge and belief true,
accurate, and complete. I am aware that there are significant penalties for submitting false
statements and information or omitting required statements and information, including the
possibility of fine or imprisonment

Transport Rule (TR) SO2 Trading Program Group II
I certify that I was selected as the Transport Rule authorized account representative or
the alternate TRSO2 authorized account representative, as applicable, by an
agreement that is binding on all persons who have an ownership interest with respect
to CAIR SO2 allowances held in the general account. I certify that I have all the
necessary authority to carry out my duties and responsibilities under the TRSO2 Group
II SO2 Trading Program on behalf of such persons and that each such person shall be
fully bound by my representations, actions, inactions, or submissions and by any order
or decision issued to me by the Administrator or a court regarding the general account.
I am authorized to make this submission on behalf of the persons having an ownership
interest with respect to the TRSO2 Group II SO2 allowances held in the general
account. I certify under penalty of law that I have personally examined, and am familiar
with, the statements and information submitted in this document and all its
attachments. Based on my inquiry of those individuals with primary responsibility for
obtaining the information, I certify that the statements and information are to the best
of my knowledge and belief true, accurate, and complete. I am aware that there are
significant penalties for submitting false statements and information or omitting
required statements and information, including the possibility of fine or imprisonment.

EPA Form 7610-5 (Revised 8-2011)

STEP 5 (Optional)
Respond to the
questions by marking all
appropriate boxes. (EPA
will use this information
for program evaluation
purposes only.)

Signature (Authorized Account Representative)

Date

Signature (Alternate Authorized Account Representative, if any)

Date

Is the authorized account representative employed by an allowance brokerage firm?
No
Yes (if yes, please mark all boxes that apply)
This account will be used to transfer allowances between clients
This account will be used to hold allowances for investment purposes
This account will be used for other purposes

What types of business are represented by the owner(s) of allowances in this account (mark all boxes
that apply)?
Utility
Non-Utility Generators of Electricity
Industrial Boiler
Fuel Supplier
_______ Coal

_______ Oil

_______ Gas

_______ Other

Pollution Control Equipment Manufacturer or distributor
Public Interest Group
_______ Consumer

_______ Other

_______ Environmental

Other ───────────────────────────────▸

EPA Form 7610-5 (Revised 8-2011)

Submission
Information

Mail to the following address:
By regular/certified mail:

Or overnight mail:

U.S. Environmental Protection Agency
Clean Air Markets Division (6204J)
Attn: Allowance Tracking System
1200 Pennsylvania Avenue, NW
Washington, DC 20460

U.S. Environmental Protection Agency
Clean Air Markets Division (6204J)
Attn: Allowance Tracking System
1310 L Street, NW
Second Floor, Office 202B
Washington, DC 20005
(202) 343-9168

EPA Form 7610-5 (Revised 8-2011)