Form 637 Questionnaires

Name:	EIN:
Address:	Registration No:
City, State, Zip

“V” QUESTIONNAIRE (Revision 02-01-2006)

Manufacturer, importer, or buyer of ozone-depleting chemicals (ODC’s) for export.

Review Form 637, "Application for Registration" for any updates or changes. This includes Part I, II, and III. Attach the updates or changes to questionnaire. Notate if no updates or changes have been made since last visitation.

1. Who is responsible for the preparation and filing of Form 720 and/or Form 8849? From what address are they filed? _______________________________________________________________________________________________________________________________________________________________________________________________________________

2. Does the company, related company, or any of its owners incur any liability for excise tax? If so, name the type of tax. __________________________________________________________________________________________________________________________________________

3. Does the company sell or plan to sell any ozone-depleting chemicals to a related company? If so, describe the arrangements.

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4. Has the company's excise, employment, or income tax returns been examined by the State or IRS during the previous five years? If so, what were the results of the examination?

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5. List the ozone-depleting chemicals you import or manufacture for export.

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6. List the name and address of companies from which you buy ozone-depleting chemicals.

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7. List the products you manufacture, import, or buy for export.

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8. List the number of pounds for each ozone-depleting chemical exported in this calendar year and an estimate for the next calendar year.

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9. List your export locations.

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10. List your production allowance, export allowance, and export percentage as set by the Environmental Protection Agency.

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11. How do you calculate the amount of credit or refund related to an exported article that contains ozone-depleting chemicals?

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12. Please describe the proof of export the company plans to obtain to verify the articles were actually exported. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

13. Provide the name and address of any brokers used to export ozone-depleting chemicals. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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