5900-508 HFC Importer Quarterly Report

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Overview

Instructions
Section 1
Section 2
Section 3
Section 4
Summary
Reference List

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Sheet 1: Instructions

	OMB Control Number: 2060-XXXX
	Expiration Date: X/XX/202X
	U.S. Environmental Protection Agency
	Allowance Allocation and Trading Program under the AIM Act
	HFC Importer Quarterly Report (Sec 84.31)
	Version 1.0
	Last Updated:
	Instructions
	Complete this form by filling in the data fields that are highlighted in blue. Guidance on how to complete individual data fields are provided in comment bubbles. Use the arrows to navigate between the tabs. Once completed, use the 'prepare submission' button on the Summary tab to generate your CSV file.
	Copying and Pasting Data: If data are pasted into this reporting form from another spreadsheet, the formatting of specific cells must be consistent with the requirements of the form in order to be
	accepted into EPA’s HFC Tracking System. Refer to the Reference List to identify the valid naming scheme for specific data fields. Additionally, select "Paste As Values" when pasting data into the form.
	Report Submission: This Excel file, the generated CSV file, and all supporting attachments should be submitted to EPA through the Central Data Exchange (CDX). Refer to EPA's website for additional information on form submission:
	https://www.epa.gov/climate-hfcs-reduction/collection-data-support-establishment-hfc-allowance-allocation-and-trading
	This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-XXXX). Responses to this collection of information are mandatory (40 CFR 84.31). 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. The public reporting and recordkeeping burden for this collection of information is estimated to be X hours per response. Send comments on the Agency’s need this formation, 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, Regulatory Support Division, U.S. Environmental Protection Agency (2821T), 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.
	EPA Form # 5900-508

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Sheet 2: Section 1

	U.S. Environmental Protection Agency
	HFC Importer Quarterly Report
	Date Prepared:
	Section 1: Report Identification Information
	Complete all fields below. No fields may be left blank.
	Company Name:
	Submission Type:
	Reporting Year:
	Reporting Quarter:
	Importer Number:
		x

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Sheet 3: Section 2

U.S. Environmental Protection Agency

HFC Importer Quarterly Report

Company Name:

Reporting Period:

Section 2: Import Transaction Data

In the table below, enter data for each import transaction containing a regulated substance that took place during the reporting period. If no regulated substances were imported, the table may be left blank. As a reminder, if material was imported for second party transformation or second party destruction, a copy of the transformation and/or destruction verification from each company for whom material was imported must be provided to EPA along with the submission of this report.

If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.

Transaction Number

Date of Import (§84.31(c)(1)(v))

Source Country (§84.31(c)(1)(vii))

Name of Regulated Substance Imported (§84.31(c)(1)(i))

Quantity of Regulated Substance Imported (§84.31(c)(1)(ii))

Commodity Code (§84.31(c)(1)(iii))

Summary of Regulated Substances Imported (§84.31(c)(2)(i))

Port of Entry into the United States (§84.31(c)(2)(vi))

Customs Entry Summary Number (§84.31(c)(2)(xii))

Shipment Importer Number (§84.31(c)(2)(ix))

Transaction Type (§84.31(c)(2)(ii))

Intended Use (§84.31(c)(1)(iv) and §84.31(c)(1)(v))

Regulated Substance in Import

Percentage of Import

Regulated Substance in Import

Percentage of Import

Regulated Substance in Import

Percentage of Import

Text

Date

Selection

Text

kg

Text

Selection

%

Selection

%

Selection

%

Text

Text

Number

Selection

Selection

x

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Sheet 4: Section 3

	U.S. Environmental Protection Agency
	HFC Importer Quarterly Report
	Company Name:
	Reporting Period:
	Section 3: Data on Shipment/Sales/Allowances Conferred
	In the table below, provide the quantity of regulated substances sold or transferred during the quarter to each person for use in processes resulting in their transformation or destruction.
	Note: Due to a potential time lag between the date of import and the date of shipment, it is recognized that for a given quarter the information in Section 3 may not match the information reported in Section 2; however, it is expected that all material imported for second party transformation or second party destruction will eventually be shipped to a second party and must be reported as such in the applicable quarterly report.
	If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.
	As a reminder, a copy of the transformation and/or destruction verification from each company for which material was imported must be provided to EPA along with the submission of this report (§84.31(c)(1)(vii)).
	Regulated Substance Name	Recipient Company Name (§84.31(c)(1)(vi))	Quantity (§84.31(c)(1)(vi))	Purpose
	Selection	Text	kg	Selection
	In the table below, identify the application-specific allowance holders from whom orders were placed and the number of application-specific allowances conferred.
	Regulated Substance Name	Application-Specific Allowance Holder (§84.31(c)(1)(iv))	Quantity Conferred (§84.31(c)(1)(iv))
	Selection	kg	kg
	x

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Sheet 5: Section 4

	U.S. Environmental Protection Agency
	HFC Importer Quarterly Report
	Company Name:
	Reporting Period:
	Section 4: End-of-Year Inventory (FOURTH QUARTER REPORT ONLY)
	In the table below, provide the quantity of each regulated substance held in inventory on December 31.
	If copying and pasting data into the table, please refer to the Reference List and the accompanying instructions.
	HFC Name	End-of-Year Inventory (§84.31(c)(1)(viii))
	Selection	kg

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Sheet 6: Summary

		U.S. Environmental Protection Agency
		HFC Importer Quarterly Report
		Company Name:
		Reporting Period:
		Import Totals
		The values in the table below are calculated based on data entered in Section 2. If the totals appear to be incorrect, please return to Section 2 to review your data.
		HFC Name	New Imports (kg)							Total Used Imports (kg)
			Gross Imports	In-House Transformation	Second Party Transformation	In-House Destruction	Second Party Destruction	Application-Specific Allowance Holders	Net Imports

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Sheet 7: Reference List

	U.S. Environmental Protection Agency
	HFC Importer Quarterly Report
	Reference List
	Copying and Pasting Data: If data are pasted into this reporting form from another spreadsheet, the formatting of specific cells must be consistent with the requirements of the form in order to be accepted into EPA’s HFC tracking system. When copying and pasting data into the form, please ensure consistency with the formatting of the list below.
	Chemical Name List: The table below lists the valid chemical names that may be used when entering data into Section 2, Section 3, and Section 4 of this form.
	Chemical Name
	HFC-23	HFC-134	HFC-152	HFC-236ea	HFC-365mfc
	HFC-32	HFC-134a	HFC-152a	HFC-236fa	HFC-43-10mee
	HFC-41	HFC-143	HFC-227ea	HFC-245ca
	HFC-125	HFC-143a	HFC-236cb	HFC-245fa