5900-06 Fee Filing (FF)

OMB No. 2060-0336,

Approval Expires 05/31/2019

Federal Operating Permit Program (40 CFR Part 71)

FEE FILING FORM (FF)

The purpose of this form is to ensure that fee payments made by check are credited to the proper facility and to the proper government account. Send this form, along with form FEE and the check, to the appropriate lockbox bank address listed on the following page. This form is required whenever you pay by check, including for initial fee payment and to pay annual fees. Part 71 fees may be paid by check or electronically, and further information on making payments by check or electronically is provided on the following page.

Source or Facility Name_________________________________________________

Source Location ____________________________________________________________

EPA Region where Source Located ____________________ _

Mailing Address:

Street/P.O. Box ______________________________

City___________________________________________________

State ______ ZIP __________ - ______

Contact Person:_____________________________

Title______________________________

Telephone ( ____ ) ____ - _ _________ Ext. __________

Total Fee Payment Remitted: $ __________________._____

TWO PAYMENT OPTIONS FOR PART 71 FEES:

OPTION 1 - CHECK PAYMENT VIA U.S. POSTAL SERVICE

• Fee payment shall be in U.S. currency drawn on a U.S. bank.

• Check should be made out to the order of the “U.S. Environmental Protection Agency."

• Indicate on the check that the payment is for “Part 71 Fee Payment.”

• Make a photocopy of the check.

• Send the following to the EPA region (or delegate agency):

• Form FEE (EPA Form 5900-03) and

• Photocopy of check

• Send the following to the address below:

• Form FF (EPA Form 5900-06) and

• Original check

Address for Regular Mail
(U.S. Postal Service):

U.S. EPA

OCFO/OC/ACAD/FCB

Attn:  Collections Team

1300 Pennsylvania Ave NW

Mail Code 2733R

Washington, DC  20004

• Tips for Completing form FF (Fee Filing Form)

• Source Location: Physical location - Street address (if any), City, County, and State.

• Mailing Address: Address for the EPA to send correspondence. This address may be different from the source location, such as a corporate office.

• EPA Region: EPA region in which the source is located (e.g., EPA Region 8).

• Contact: Person that can best answer questions concerning fee payment.

OPTION 2 – ONLINE PAYMENT

• Part 71 fees can be paid online at www.pay.gov using form “SFO 1.1 (EPA Miscellaneous Payments - Cincinnati Finance Center).” Note that EPA Form 5900-06 cannot be used for online payments.

• Tips for completing online form SFO 1.1:

• From the “Type of Payment” drop down menu, select “Other/Miscellaneous”

• On the “Bill# or description” line, enter “Part 71 Fee Payment”

• In the “Comments” box, enter the source or facility name and the part 71 permit number associated with this payment.

• After submitting payment online, send the following to the EPA region (or delegate agency):

• Form FEE (EPA Form 5900-03) and

• Copy of the electronic payment confirmation generated by the online payment system.

• FOR MORE INFORMATION: The following link provides detailed information on how to make payments to EPA for part 71 fees, penalties, and interest, including contact information for EPA’s Accounts Receivable Branch in Cincinnati https://www.epa.gov/financial/makepayment

• Questions/inquiries may be sent to: [email protected]

Laura Collier - [email protected]  

Stacey Church - [email protected]

EPA Form 5900-06 Updated 11/20/2018