5900-509 HFC International Transfers Report

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Overview

Instructions
Section 1
Section 2
Section 3

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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 International Transfers Report (Sec 84.19)
	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 ODS 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 # 5900-509

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Sheet 2: Section 1

	U.S. Environmental Protection Agency
	HFC International Transfers Report
	Date Prepared:
	Section 1: Identification Information
	Complete all fields below. No fields may be left blank.
	Company Name:
	Submission Type:
	Reporting Year:
	Transfer Type:

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Sheet 3: Section 2

		U.S. Environmental Protection Agency
	Err:508	HFC International Transfers Report
		Company Name:
		Reporting Period:
		Section 2: Contact Information
		In the table below, identify the foreign country authorizing the transfer and enter the contact information for the person in the foreign country that is authorizing the transfer.
		For a transfer from a person in a foreign country, additionally provide a signed document from an official representative in that country’s embassy in the United States stating that the appropriate authority within that country has revised the domestic production limits for that country equal to the lowest of the following three production quantities: (A) The maximum production level permitted in § 84.7(b) in the year of the international transfer minus the quantity of production allowances (in exchange value-weighted kilograms) to be transferred; (B) The maximum production level for the applicable regulated substances that are allowed under applicable law (including the foreign country's applicable domestic law) minus the quantity of production allowances (in exchange value-weighted kilograms) to be transferred; or (C) The average of the foreign country's actual national production level of the applicable regulated substances for the three calendar years prior to the year of the transfer minus the quantity of production allowances (in exchange value-weighted kilograms) to be transferred.
		For a transfer to a person in a foreign country, additionally provide a signed statement from a responsible official requesting that the relevant Agency official revise the number of production allowances the transferor holds such that the aggregate national production in the United States is equal the lowest of the following three production quantities: (A) The maximum production level permitted in § 84.7(b) in the year of the international transfer minus the quantity of production allowances (in exchange value-weighted kilograms) to be transferred; (B) The maximum production for the applicable regulated substances that are allowed under applicable law minus the quantity of production allowances (in exchange value-weighted kilograms) to be transferred; or (C) The average of the United States’ actual national production level of the applicable regulated substances for the three calendar years prior to the year of the transfer minus the quantity of production allowances (in exchange value-weighted kilograms) to be transferred.
		Foreign Country Authorizing Transfer (§84.19(b)(2)(ii)(B) or (§84.19(b)(3)(ii))	Contact Name (§84.19(b)(2)(ii)(C) or (§84.19(b)(3)(iii))	Contact Phone Number (§84.19(b)(2)(ii)(C) or (§84.19(b)(3)(iii))	Contact Email (§84.19(b)(2)(ii)(C) or (§84.19(b)(3)(iii))	x
		Selection	Text	Text	Text	x
						x
			x		x	x

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Sheet 4: Section 3

		U.S. Environmental Protection Agency
		HFC International Transfers Report
		Company Name:
		Reporting Period:
		Section 3: Transaction Data
		In the table below, enter data for each transfer request.
		For transfers from a person in a foreign country, additionally provide documentation that the foreign country possesses the necessary quantity of unexpended production rights (§84.19(b)(2)(ii)(E)) and a signed statement from a responsible official describing whether the increased production is intended for export or the market in the United States (§84.19(b)(2)(ii)(G)).
		Transaction Number	Chemical Name	Quantity of Production Allowances Being Transferred ((§84.19(b)(2)(ii)(D) or §84.19(b)(3)(iv))
		Autopopulated	Selection	kg
0
				x