Form DOE/FCVT/101 EPAct State & Alternative Fuel Provider Program

U.S. Department of Energy

EPAct

Fleet Information
& Regulations

State & Alternative Fuel Provider Rule

Guidance

Annual AFV Reporting for State and Alternative Fuel Provider Fleets
This document provides instructions for state and
alternative fuel provider fleets for the form fleets
need to complete to be in compliance with EPAct.
As stated and defined in “The Blue Book” (A Guidebook to the U.S. DOE’s Alternative Fuel Transportation
Program for State and Alternative Fuel Provider Fleets),
state government organizations and alternative fuel
providers are covered by EPAct alternative fuel
vehicle (AFV) requirements if:
• The organization owns, operates, leases, or
otherwise controls 50 or more light-duty vehicles
(LDVs) in the United States that are not on the list
of excluded vehicles.
• Twenty of these 50 LDVs are used primarily
within any metropolitan statistical area (MSA) or
consolidated metropolitan statistical area (CMSA).
• Those same 20 LDVs are centrally fueled or
capable of being centrally fueled
Each covered fleet is required to submit an annual
fleet report of the total number of LDVs acquired during
the model year (MY), details about each AFV acquired,
and the number of biodiesel fuel use credits claimed.

When to Submit Reporting Data
Fleets should have available all of the information
requested in the Annual AFV Acquisition Report
for State and Alternative Fuel Provider Fleets (Form
DOE/FCVT/101). Line-by-line instructions are
detailed in this guidance.
The Annual AFV Acquisition Report must be filed
with DOE by December 31 of each respective model
year. For example, DOE must receive data for a fleet’s
AFV acquisitions for MY 2001 by December 31, 2001.
Reports received after this date will be late and considered to be in violation of the Alternative Fuel Trans
portation Program, as per 10 CFR part 490, subpart G.
Failure to report may result in a civil penalty of
not more than $5,000 for each violation, a criminal
fine of not more than $10,000 for each willful

violation, or a criminal fine of not more than $50,000
for each knowing and willful violation.

Where to Submit Reporting Data
There are several ways to submit the data.
• Online: Log on to the online reporting database
at www.eere.energy.gov/vehiclesandfuels/epact/
state/poc_login.shtml with your fleet user name
and password. (For more information, visit
www.eere.energy.gov/vehiclesandfuels/epact/
state/reporting.shtml.)
• Electronically: Download spreadsheet from
www.eere.energy.gov/vehiclesandfuels/epact/docs
/fleet_report_05_2004.xls. You can then develop a
spreadsheet file, complete the form, and e-mail it to:
[email protected].
• Fax: Download a PDF of the acquisition report
from www.eere.energy.gov/vehiclesandfuels/
epact/docs/fleet_report_05_2004.xls. Fill out the
form via computer, and fax it to:
(703) 480-9359
You can also print out the form and mail to Jaycor
at the address above.
• U.S. mail: Fill out the attached form and mail the
original to the database contractor at:
L-3 Communications Group
AFV Project Office
11410 Isaac Newton Square N., Suite 103
Reston, VA 20190

Parents and Subsidiaries/Affiliates
The responsible reporting party for the program is the
parent or holding company. The parent company may
choose to report for itself and all its subsidiary organizations or have each subsidiary report independently.
If the parent company reports for itself and all
subsidiary organizations, the parent company should

February 2006

State & Alternative Fuel Provider Program

Guidance

note this in the remarks section and identify the
subsidiaries for which it is reporting. DOE prefers
that the parent company file a separate report for
each subsidiary.
Conversely, if the parent company reports for
itself, that company is asked to ensure that each
subsidiary with reporting requirements reports
independently. To help DOE determine the parent/
subsidiary relationship, reports should identify the
parent company as the Company/State Name and
the subsidiary as the Fleet/Agency Name.

States and State Agencies
Each state may choose to report for itself and all
its agencies, have a central agency report for the
majority of state vehicles, and have the remaining

agencies report independently; or have each state
agency report independently. If the state reports for
itself and all its agencies, the state should note this in
the remarks section and identify the agencies for
which it is reporting.
If a central agency is reporting for the majority of
state vehicles, that agency is asked to identify the
agencies for which it is reporting and to identify the
other state agencies for which reports are expected
to be forthcoming.
If state agencies will be submitting reports
independently, the state is asked to ensure that each
agency with reporting requirements report its AFV
acquisitions to DOE. To help DOE determine the
parent/subsidiary relationship, reports should
identify the state as the Company/State Name and
the state agency as the Fleet/Agency Name.

Instructions: Completing the Annual AFV Acquisition Report
Part A: Fleet Identification

Part A of Form DOE/FCVT/101

Fleet/Agency Name (mandatory):
Enter the company or state agency name
EPAct - State & Alternative Fuel Provider Program
Form DOE/FCVT/101
(e.g., Gas Distribution Fleet, Department
Annual AFV Acquisition Report for State and Alternative Fuel Provider Fleets
of Transportation).
Collection of data for this program has been approved by the Office of Management and Budget (OMB). The OMB control number for this
activity is 1910-5101. Respondents are not required to file a reply to any federal collection of information unless it has a valid OMB control
Company/State Name (mandatory):
number. Public reporting burden for this collection of information is estimated to average 5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data, and completing and reviewing the collection of informaFor fuel providers, this is the corporation
tion. Reporting forms and tools for online reporting for state and alternative fuel provider fleets are available at www.eere.energy.gov/
vehiclesandfuels/epact/state/index.shtml.
that owns them. For state agencies, it’s
Part A - Fleet Identification
Fleet/Agency Name: ________________________________________ Consolidated Metropolitan Statistical Area: ______________________
the state where they’re located (e.g.,
Company/State Name: ______________________________________ Fleet Type: __________________________________________________
AAA Gas Co., State of Illinois).
Point of Contact Name: ______________________________________ Point of Contact Phone: ________________________________________
Point of Contact (mandatory): Enter
Mailing Address: ____________________________________________ Point of Contact Fax: __________________________________________
____________________________________________ Point of Contact E-mail: ________________________________________
the name of the organization’s fleet
____________________________________________ Today’s Date: ________________________________________________
manager or other contact person. If DOE
City: ____________________________________________ Do you want your fleet and your name and phone number included
on the publicly accessible list of those fleets
has questions concerning this report, it
State: __________________ Zip: ____________________ possessing excess credits available for sale? Yes ______ No ______
will call the fleet’s point of contact.
Remarks: __________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
Address, City, State, Zip (mandatory):
____________________________________________________________________________________________________________________________
Enter the complete mailing address of
your fleet’s location.
CMSA/MSA (mandatory): Enter the
• P: Alternative fuel provider, which is a fuel
CMSA/MSA where your fleet is located. See
provider whose principal business is to produce,
www.ott.doe.gov/epact/cgi-bin/fleet/dyn_msa.cgi for
store, refine, process, transport, distribute, import,
a list of CMSAs and MSAs.
or sell (wholesale or retail) any alternative fuel
Fleet Type (mandatory): There are four options.
(other than electricity); or generate, transmit, import,
Enter the code that best describes your fleet:
or sell (wholesale or retail) electricity; or to import
or produce and import an average of 50,000 barrels
• S: State government organization, which meets
per day or more of petroleum; and 30% or more
the criteria of 50 vehicles in a CMSA/MSA, 20 of
of its gross annual revenues are derived from
which can be centrally fueled.
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State & Alternative Fuel Provider Program

Guidance

producing alternative fuels. A fuel provider is not
covered if its principal business is to transform
alternative fuel into products that are not alternative
fuels or if its principal business is that of using an
alternative fuel as a feedstock or fuel in the manufacture of products that are not alternative fuels.
• E: Approved by DOE for electric utility delay.
This is a fuel provider whose principal business is
generating, transmitting, importing, or selling
electricity.
• B: Biodiesel fuel provider, whose principal
business is to produce, store, refine, process,
transport, distribute, import, or sell (wholesale or
retail) biodiesel fuel. In this case, “principal
business” is the company’s largest sales-related
gross revenue producing activity. If an organization
derives a plurality of gross revenue from salesrelated biodiesel fuels activity, the organization’s
principal business is biodiesel fuels.
Point of Contact Phone, Fax, and E-mail
(mandatory): Enter the contact information for fleet
manager or other point of contact.
Today’s Date (mandatory): Enter the date on
which you completed the form.

Part B: Light-Duty Vehicles Acquired

The reporting model year for the Biodiesel Fuel
Use Credit also runs from September 1 through
August 31.
Total Vehicles Acquired (mandatory for MY 1997
and beyond): This is the total number of LDVs (AFVs
and conventional vehicles) acquired (purchased or
leased) by the fleet during the reporting model year.
This number is used to determine the fleet’s requirement for AFV purchases for this particular year. For
reports of AFVs purchased before the program
requirements began (before MY 1997 for most fleets,
before MY 1998 for electric delay fleets). The number
in this field will equal the total number of AFVs
acquired during that model year (fleets need not
report non-AFV acquisitions before MY 1997 since
the required AFV acquisition percentage is zero for
early years).
Total Alternative Fueled Vehicles Acquisition
Requirements (mandatory): To calculate total AFV
acquisition requirements for the given model year,
multiply the total number of LDVs acquired by the
AFV percentage purchase requirements for that
model year and round to the nearest whole number.
Fractions greater than or equal to one half (0.5)
should be rounded up; fractions less than 0.5 should
be rounded down.
The following table gives the AFV percentage
purchase requirements for covered fleets by
model year.

Model Year (mandatory): MY runs from September 1
through August 31. For example, MY 2001 was
September 1, 2000, through August 31,
2001. AFV purchases made in previous
Part B of Form DOE/FCVT/101
years can also be reported, but a separate
annual fleet report form should be completed for each model year.
EPAct - State & Alternative Fuel Provider Program
Form DOE/FCVT/101
There are two exceptions to this
Annual AFV Acquisition Report for State and Alternative Fuel Provider Fleets
definition:
Part B - Light-duty Vehicles (LDVs) Acquired
• For early years (those before acquisiLDVs Acquired: Model Year _____ Data
tion requirements began through MY
Total Vehicles Acquired: Enter the quantity of LDVs acquired during the ______ model year, including all alternative fueled vehicles
(AFVs), plus all non-alternative fueled vehicles (do not count excluded vehicles). The total number of LDVs acquired is necessary for DOE
1997 for all but electric delay fleets,
to verify the number of AFVs that a fleet must acquire. A model year runs from September 1 to August 31.
Model Year: ______________________________________
MY 1998 for electric delay fleets), the
Total LDVs Acquired: ______________________________________
MY coincides with the calendar year
Total AFV Acquisition Requirements*: ______________________________________
(January 1 through December 31).
*To calculate Total Model Year AFV Acquisition Requirements do the following:
• For electric delay fleets, MY 1998
_____ For state fleets, multiply Total LDVs Acquired by 0.75 and round to the nearest whole number.
(when their acquisition requirements
_____ For fuel provider fleets, including electric utilities, multiply Total LDVs Acquired by 0.90 and round to the nearest whole number.
began) ran from January 1, 1998,
Note: In rounding to nearest whole number, fractions greater than or equal to one half (0.5) should be rounded up and fractions less than
one half should be rounded down.
through December 31, 1998. Subsequent model years are the same as
defined earlier.
February 2004

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State & Alternative Fuel Provider Program

Guidance

AFV Percentage Purchase Requirements for Covered Fleets by Model Year
Model Year

State Fleets

Fuel Provider Fleets

Electric Utility Option Fleets

1997

10%

30%

N/A

1998

15%

50%

30%*

1999

25%

70%

50%

2000

50%

90% for MY 2000
and beyond

70%

2001

75% for MY 2001
and beyond

90%

90% for MY 2001
and beyond

* Electric utility option for MY 1998 covered only acquisitions made between January 1, 1998, through August 31, 1998. All other model
years run from September 1 through August 31.

Banked Credits Applied: Fleets that acquire more
AFVs than required in a given model year earn credits
for extra acquisitions. These “banked credits” can be
applied to meet acquisition requirements in another
year to attain compliance. Each credit applied is the
equivalent of one AFV acquisition.

Part C: Annual AFV Fleet Report

year the vehicle was converted to an AFV if it is a
converted vehicle).
Vehicle Category (mandatory): Enter the code for
the vehicle type.
• Automobile: Auto
• Light-Duty Pickup: LDPu (<8,500 lbs. GVWR)
• MiniVan: MVan
• Full Size Van/Wagon: FSVan
• Sport Utility Vehicle: SUV
• Bus: Bus
• Medium-Duty Truck: MDT (8,500 to 26,000 lbs.)
• Heavy-Duty Truck: HDT (>= 26,000 lbs.)

Fleet Name (mandatory): Enter the company or
state agency name.
Today’s Date (mandatory): Enter the date on which
you completed the form.
Alternative Fueled Vehicle Data (mandatory):
Specific information about each AFV
should be provided in the vehicle data
section of the Annual AFV Fleet Report.
Part C of Form DOE/FCVT/101
This number represents all AFVs acquired
during the reporting model year. As such,
EPAct - State & Alternative Fuel Provider Program
Form DOE/FCVT/101
it is a subset of the Total Light Duty
Annual AFV Acquisition Report for State and Alternative Fuel Provider Fleets
Vehicles Acquired section in Part B.
Part C - Annual AFV Fleet Report
Do not report details about non-AFVs
Fleet Name:__________________________________________________ Today’s Date:______________________
Alternative Fueled Vehicle Data (Use continuation sheet as necessary for additional AFVs for this model year.)
in Part C. You should make enough copies
Veh.
Model
Veh.
Acq.
Conv.
Fuel
Fuel
Conv.
Lightso you can report all your AFVs for a given
Num.
Make
Model
Year
Cat.
VIN
Date
Date
Type
Config.
Mode duty Ind.
model year.
Vehicle Number (optional): Enter a
sequential number of AFVs for your
tracking purposes.
Make (mandatory): Enter the make/
manufacturer of the AFV (e.g., Ford,
Plymouth, Dodge).
Model (mandatory): Enter the AFV
model (e.g., Caravan, Taurus, Cavalier).
Model Year (mandatory): Enter the year
the vehicle was manufactured (not the
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February 2006

Veh.
Zip

State & Alternative Fuel Provider Program

Guidance

VIN (mandatory): Enter the 17-character alphanumeric Vehicle Identification Number (VIN) that is
assigned by the vehicle manufacturer.
Acquisition Date (mandatory): Enter the date your
fleet purchased or otherwise acquired the vehicle.
Use the MM/DD/YYYY format to enter these data.
Conversion Date (mandatory for AFVs converted
by your fleet): Enter the date the vehicle was
converted to an AFV. Leave this blank for vehicles
that were built as AFVs. The law allows vehicles that
were converted within four months from the date
they were acquired by the fleet. AFVs acquired before
the program went into effect (September 1, 1996),
but after the law was passed (October 24, 1992), are
not subject to this requirement and are allowed in
the program no matter when they were converted to
AFVs. Use the MM/DD/YYYY format to enter these
data.
Fuel Type (mandatory): Enter the code for the type
of alternative fuel that the vehicle uses.
• 85% Ethanol: E85
• 100% Biodiesel: B100
• Electricity: Elec
• Liquefied Petroleum Gas: LPG
• Compressed Natural Gas: CNG
• Liquefied Natural Gas: LNG
Fuel Configuration (mandatory): Enter
the code for the vehicle’s type of fuel
configuration.
• Dedicated: Ded (A vehicle designed
and engineered to operate solely on
an alternative fuel.)
• Dual/Bi-Fuel: Dual (A vehicle that
can operate on two different fuels
either separately or as a mixture.)
• Flexible Fuel: Flex (A vehicle that has
a single fuel storage and combustion
system that can be fueled with either
a blended alcohol fuel, a traditional
fuel, or any combination of the fuels.)
• Fuel Cell: Cell (A vehicle engineered
to operate on fuel cell technology.)
Conversion Mode (mandatory): Enter
the code for the proper conversion.

• OEM: Designed by the original equipment
manufacturer to run on alternative fuel.
• PCon: Converted by a previous owner to run on
alternative fuel.
• SCon: Converted by you to run on alternative
fuel (self-converted).
Light-Duty Indicator (mandatory): This field is used
to indicate whether the vehicle can be considered an
LDV. Choose yes or no.
• Y (Yes): Gross Vehicle Weight <=8,500 lbs.
• N (No): Gross Vehicle Weight is >8,500 lbs.
Vehicle Zip Code: This field is used to indicate the
zip code where the vehicle is garaged. If you do not
know a vehicle’s specific location, enter the fleet’s
zip code.

Part D: Biodiesel Fuel Use Credits
Biodiesel fuel use credits became available after
the Energy Conservation Reauthorization Act of
1998 was enacted. MY 1999 was a partial year for
earning credits for biodiesel use, beginning
November 14, 1998—the date the act was signed into
law. After that, model years for the availability of the
biodiesel fuel use credit coincide with the standard
model year definition of September 1 through
August 31.

Part D of Form DOE/FCVT/101
EPAct -

State & Alternative Fuel Provider Program

Form DOE/FCVT/101

February 2004

Annual AFV Acquisition Report for State and Alternative Fuel Provider Fleets
Part D - Biodiesel Fuel Use Credits
Biodiesel Fuel Use Credits(1) Claimed for Model Year ______
1. Are you a Biodiesel Fuel Provider (2)?

Yes _____ No _____

2. Total Biodiesel (3) purchased in model year ______ for use in vehicles with Gross Vehicle
Weight Rating (GVWR) in excess of 8,500 lbs. (Note that this number should be the net
amount of biodiesel fuel purchased for use in vehicles in excess of 8,500 lbs. GVWR.
Any biodiesel purchased and then sold to another party should not be included in
Total Biodiesel Purchased.)

____________ Gallons

3. Potential Biodiesel Fuel Use Credits Claimed (Divide line #2 by 450 and round down
to the next whole number.)

____________ Potential Credits

4. Total number of Biodiesel Fuel Use Credits Claimed (Cannot exceed 50% of total AFV
purchase requirements as listed in Part B except for Biodiesel Fuel Providers. For Biodiesel
Fuel Providers, total number of Biodiesel Fuel Use Credits cannot exceed total AFV
purchase requirements as listed in Part B.)

____________ Actual Credits

(1)

The Biodiesel Fuel Use Credit became available following the enactment of the Energy Conservation Reauthorization Act of 1998. The 1999 model year for the use of
the Biodiesel Fuel Use Credit runs from November 14, 1998, to August 31, 1999. In subsequent model years, the availability of the Biodiesel Fuel Use Credit is from
September 1 through August 31.

(2)

A Biodiesel Fuel Provider is a fuel provider whose “principal business” is producing, storing, refining, processing, transporting, distributing, importing, or selling
(wholesale or retail) biodiesel fuel where the term “principal business” means the largest sales-related gross revenue producing activity. If an organization derives a
plurality of gross revenue from sales-related biodiesel fuels activity, the organization’s principal business is biodiesel fuels.

(3)

Report biodiesel purchased as neat, or 100%, biodiesel. If biodiesel was purchased as biodiesel blends of 20% or higher, only report the biodiesel portions of such
blends (e.g., 2,250 gallons of B20—blends of 20% biodiesel and 80% petroleum diesel—should be reported as 450 gallons of neat biodiesel). Biodiesel purchased in
blends containing less than 20% biodiesel by volume are not eligible for the Biodiesel Fuel Use Credit.

February 2006

State & Alternative Fuel Provider Program

Guidance

Biodiesel Fuel Provider: Any reporting
Part E of Form DOE/FCVT/101
fleet whose principal business is to produce,
store, refine, process, transport, distribute,
EPAct - State & Alternative Fuel Provider Program
Form DOE/FCVT/101
import, or sell (wholesale or retail)
biodiesel fuel. In this case, “principal
Annual AFV Acquisition Report for State and Alternative Fuel Provider Fleets
business” is the company’s largest salesPart E – Applying Credits
related gross revenue producing activity.
1. Would you like to apply banked credits from a previous year to your annual credit balance? Yes _____ No _____
If an organization derives a plurality of
2. How many credits would you like to apply? _________________
gross revenue from sales-related biodiesel
fuels activity, the organization’s principal
business is biodiesel fuels.
you’ve only acquired 20, you may use banked credits
Total Biodiesel Purchased: Report total biodiesel
in your account to satisfy your requirements.
purchased for the given model year for use in vehicles
Number of Credits: Enter the number of credits
with GVWR in excess of 8,500 lbs. The biodiesel
you would like to apply. For example, if your annual
reported as purchased should be the net amount of
requirement is for 25 AFVs and you have only
biodiesel fuel purchased for use in vehicles in excess
acquired 20, you could enter 5 to bring your fleet into
of 8,500 lbs. GVWR. Any biodiesel purchased and
compliance for the year. The number of credits entered
then sold to another party should not be included in
must be available in your account balance. If fewer
Total Biodiesel Purchased. Also report biodiesel
credits are available the remainder will be applied.
purchased as neat, or 100%, biodiesel.
If biodiesel was purchased as biodiesel blends of
20% or higher, report only the biodiesel portions of
What is EPAct?
such blends (e.g., 2,250 gallons of B20 blends (20%
biodiesel and 80% petroleum diesel) should be
The Energy Policy Act of 1992, or EPAct, was passed by
reported as 450 gallons of neat biodiesel). Biodiesel
Congress to reduce the nation's dependence on imported petroleum. Provisions of EPAct require certain fleets to purchase alterpurchased in blends containing less than 20%
native fuel vehicles. DOE administers the regulations through its
biodiesel by volume are not eligible for the biodiesel
State & Fuel Provider Program, Federal Fleet Program, Private &
fuel use credit.
Local Government Program, and Fuel Petition Program. EPAct
Potential Biodiesel Fuel Use Credits: Potential
also includes voluntary programs, such as Clean Cities, which
help accelerate the use of alternative fuels in transportation.
biodiesel fuel use credits are derived by dividing total
biodiesel purchased in line 2 by 450. This number
For more information, visit
www.eere.energy.gov/vehiclesandfuels/epact/,
should be rounded down to the next whole number.
or call the Regulatory Information Line at (202) 586-9171.
Total Number of Biodiesel Fuel Use Credits Claims:
For fleets that are not biodiesel fuel providers, the
Sponsored by the U.S. Department of Energy
Energy Efficiency and Renewable Energy
actual number of biodiesel fuel use credits claimed
FreedomCAR & Vehicle Technologies Program
cannot exceed 50% of total AFV purchase requirePrepared by
ments (rounded down to the nearest whole number)
the National Renewable Energy Laboratory (NREL)
NREL is a U.S. Department of Energy National Laboratory
as listed in Part B. For biodiesel fuel providers, the
Operated by Midwest Research Institute • Battelle • Bechtel
number of biodiesel fuel use credits claimed cannot
DOE/GO-102001-1366
exceed total AFV purchase requirements as listed in
Revised February 2006
Printed with a renewable-source ink on paper containing
Part B.
at least 50% wastepaper, including 10% postconsumer waste
February 2004

Part E: Applying Credits
Applying Banked Credits: Select “Yes” if you
would like to apply banked credits toward meeting
your requirements for the current year. For example,
if your annual requirement is for 25 AFVs, and

Neither the United States government nor any agency thereof, nor any of their employees,
makes any warranty, express or implied, or assumes any legal liability or responsibility for
the accuracy, completeness, or usefulness of any information, apparatus, product, or
process disclosed, or represents that its use would not infringe privately owned rights.
Reference herein to any specific commercial product, process, or service by trade name,
trademark, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, recommendation, or favoring by the United States government or any agency thereof. The views and opinions of authors expressed herein do not necessarily state or reflect
those of the United States government or any agency thereof.

February 2006

EPAct -

State & Alternative Fuel Provider Program

Form DOE/FCVT/101

Revised February 2006

Annual AFV Acquisition Report for State and Alternative Fuel Provider Fleets
Collection of data for this program has been approved by the Office of Management and Budget (OMB). The OMB control number for this
activity is 1910-5101. Respondents are not required to file a reply to any federal collection of information unless it has a valid OMB control
number. Public reporting burden for this collection of information is estimated to average 5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data, and completing and reviewing the collection of information. Reporting forms and tools for online reporting for state and alternative fuel provider fleets are available at www.eere.energy.gov/
vehiclesandfuels/epact/state/index.shtml.

Part A - Fleet Identification
Fleet/Agency Name: ________________________________________

Consolidated Metropolitan Statistical Area: ______________________

Company/State Name: ______________________________________

Fleet Type: __________________________________________________

Point of Contact Name: ______________________________________

Point of Contact Phone: ________________________________________

Mailing Address: ____________________________________________

Point of Contact Fax: __________________________________________

____________________________________________

Point of Contact E-mail: ________________________________________

____________________________________________

Today’s Date: ________________________________________________

City: ____________________________________________

Do you want your fleet and your name and phone number included
on the publicly accessible list of those fleets
possessing excess credits available for sale? Yes ______ No ______

State: __________________ Zip: ____________________

Remarks: __________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________

EPAct -

State & Alternative Fuel Provider Program

Form DOE/FCVT/101

Revised February 2006

Annual AFV Acquisition Report for State and Alternative Fuel Provider Fleets
Part B - Light-duty Vehicles (LDVs) Acquired
LDVs Acquired: Model Year _____ Data
Total Vehicles Acquired: Enter the quantity of LDVs acquired during the ______ model year, including all alternative fueled vehicles
(AFVs), plus all non-alternative fueled vehicles (do not count excluded vehicles). The total number of LDVs acquired is necessary for DOE
to verify the number of AFVs that a fleet must acquire. A model year runs from September 1 to August 31.
Model Year: ______________________________________
Total LDVs Acquired: ______________________________________
Total AFV Acquisition Requirements*: ______________________________________
*To calculate Total Model Year AFV Acquisition Requirements do the following:
_____ For state fleets, multiply Total LDVs Acquired by 0.75 and round to the nearest whole number.
_____ For fuel provider fleets, including electric utilities, multiply Total LDVs Acquired by 0.90 and round to the nearest whole number.
Note: In rounding to nearest whole number, fractions greater than or equal to one half (0.5) should be rounded up and fractions less than
one half should be rounded down.

EPAct -

State & Alternative Fuel Provider Program

Form DOE/FCVT/101

Revised February 2006

Annual AFV Acquisition Report for State and Alternative Fuel Provider Fleets
Part C - Annual AFV Fleet Report
Fleet Name:__________________________________________________ Today’s Date:______________________
Alternative Fueled Vehicle Data (Use continuation sheet as necessary for additional AFVs for this model year.)
Veh.
Num.

Make

Model

Model
Year

Veh.
Cat.

VIN

Acq.
Date

Conv.
Date

Fuel
Type

Fuel
Config.

Conv.
Mode

Lightduty Ind.

Veh.
Zip

EPAct -

State & Alternative Fuel Provider Program

Form DOE/FCVT/101

Revised February 2006

Annual AFV Acquisition Report for State and Alternative Fuel Provider Fleets
Part D - Biodiesel Fuel Use Credits
Biodiesel Fuel Use Credits(1) Claimed for Model Year ______
1. Are you a Biodiesel Fuel Provider (2)?

Yes _____ No _____

2. Total Biodiesel (3) purchased in model year ______ for use in vehicles with Gross Vehicle
Weight Rating (GVWR) in excess of 8,500 lbs. (Note that this number should be the net
amount of biodiesel fuel purchased for use in vehicles in excess of 8,500 lbs. GVWR.
Any biodiesel purchased and then sold to another party should not be included in
Total Biodiesel Purchased.)

____________ Gallons

3. Potential Biodiesel Fuel Use Credits Claimed (Divide line #2 by 450 and round down
to the next whole number.)

____________ Potential Credits

4. Total number of Biodiesel Fuel Use Credits Claimed (Cannot exceed 50% of total AFV
purchase requirements as listed in Part B except for Biodiesel Fuel Providers. For Biodiesel
Fuel Providers, total number of Biodiesel Fuel Use Credits cannot exceed total AFV
purchase requirements as listed in Part B.)

____________ Actual Credits

(1)

The Biodiesel Fuel Use Credit became available following the enactment of the Energy Conservation Reauthorization Act of 1998. The 1999 model year for the use of
the Biodiesel Fuel Use Credit runs from November 14, 1998, to August 31, 1999. In subsequent model years, the availability of the Biodiesel Fuel Use Credit is from
September 1 through August 31.

(2)

A Biodiesel Fuel Provider is a fuel provider whose “principal business” is producing, storing, refining, processing, transporting, distributing, importing, or selling
(wholesale or retail) biodiesel fuel where the term “principal business” means the largest sales-related gross revenue producing activity. If an organization derives a
plurality of gross revenue from sales-related biodiesel fuels activity, the organization’s principal business is biodiesel fuels.

(3)

Report biodiesel purchased as neat, or 100%, biodiesel. If biodiesel was purchased as biodiesel blends of 20% or higher, only report the biodiesel portions of such
blends (e.g., 2,250 gallons of B20—blends of 20% biodiesel and 80% petroleum diesel—should be reported as 450 gallons of neat biodiesel). Biodiesel purchased in
blends containing less than 20% biodiesel by volume are not eligible for the Biodiesel Fuel Use Credit.

EPAct -

State & Alternative Fuel Provider Program

Form DOE/FCVT/101

Revised February 2006

Annual AFV Acquisition Report for State and Alternative Fuel Provider Fleets
Part E – Applying Credits
1. Would you like to apply banked credits from a previous year to your annual credit balance?
2. How many credits would you like to apply? _________________

Yes _____ No _____