5900-551 HFC Application-Specific Allowance Holder Biannual

Hydrofluorocarbon Allowance Allocation and Trading Program (Final Rule)

HFC Application-Specific Allowance Holder Biannual Reporting Form r0.1.xlsx

Hydrofluorocarbon Allowance Allocation and Trading Program

OMB: 2060-0734

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 2060-0734 can be found here:

Document [xlsx]

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Overview

Company Information
Annual Reporting
Lists

Sheet 1: Company Information

					OMB Control Number: 2060-XXXX
					Expiration Date: X/XX/202X

	American Innovation and Manufacturing Act - HFC Application-Specific Allowance Holder Biannual Reporting Form

	Worksheet Instructions:

	Version:
	r0.1
	Updated:
	9/24/2021
	External Links:

	Reporting Form Navigation:
	Section 1 - Company Identification	Section 4 - Transition Plan
	Section 2 - Application-Specific Data	Section 5 - Additional Application-Specific Allowances for Next Calendar Year
	Section 3 - Allowance Conferral Data	Section 6 - Contracting Information

	Section 1 - Company Identification
	Instructions: Complete the following company information.
	Company Name:
	AIMRS Company ID:
	Reporting Year:
	Reporting Period:

	Section 2 - Application-Specific Data
	Instructions: Enter the quantity of each regulated substance that was acquired through conferring allowances, directly imported, or purchased without expending application-specific allowances (i.e., from the open market) during the previous six months. Additionally, provide the quantity held in inventory on the last day of the previous six-month period, and the quantity destroyed or recycled during the previous six months.

	Acquired, Held in Inventory, Destroyed or Recycled
	1	2	4	5	7	8	9
	HFC	Quantity Acquired through Conferring Allowances (kg) §84.31(h)(1)(i)	Quantity Acquired through Expending Allowances and Directly Imported (kg) §84.31(h)(1)(ii)	Quantity Purchased for Application-Specific Allowances without Expending Application-Specific Allowances (kg) §84.31(h)(1)(iii)	Quantity Held in Inventory by the Reporting Company or Held under Contract by Another Company for the Reporting Company’s Use (kg) §84.31(h)(1)(iv)	Quantity Destroyed (kg) §84.31(h)(1)(v)	Quantity Recycled (kg) §84.31(h)(1)(v)






1
2
3
4

	Section 3 - Allowance Conferral Data
	Instructions: Provide the names of the companies to which application-specific allowances were conferred.
	HFC Allowance Conferral Data
	1	2	3	4	5	6	7
	HFC	Company to Which Allowances Were Conferred	Company Contact Name §84.31(h)(1)(vi)	Company Contact Email §84.31(h)(1)(vi)	Company Contact Phone §84.31(h)(1)(vi)	Quantiy of Allowances Conferred (kg) §84.31(h)(1)(vi)	Quantity of HFC Received (kg) §84.31(h)(1)(vi)


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2
3
4
5

	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 12 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 # 5900-551

Sheet 2: Annual Reporting

							OMB Control Number: 2060-XXXX
							Expiration Date: X/XX/202X

	American Innovation and Manufacturing Act - HFC Application-Specific Allowance Holder Biannual Reporting Form

	Worksheet Instructions:

	Version:
	r0.1
	Updated:
	9/24/2021
	External Links:

	Reporting Form Navigation:
	Section 1 - Company Identification	Section 4 - Transition Plan
	Section 2 - Application-Specific Data	Section 5 - Additional Application-Specific Allowances for Next Calendar Year
	Section 3 - Allowance Conferral Data	Section 6 - Contracting Information

	Section 4 - Transition Plan
	Provide a description of plans to transition application-specific use of regulated substances to regulated substances with a lower exchange value or alternatives to regulated substances. §84.31(h)(1)(vii)








	Section 5 - Additional Application-Specific Allowances for Next Calendar Year
	Instructions: If the company is requesting additional allowances due to one or more of the circumstances listed in 84.13(b)(1), provide a projection of the monthly quantity of additional regulated substances needed for application-specific uses by month in the next calendar year.
	Quantity Needed for Application-Specific Use (kg) §84.31(h)(1)(viii)
	1	2	3	4	5	6	7	8	9	10	11	12	13	14
	HFC	January	February	March	April	May	June	July	August	September	October	November	December	Total
1														0.00
2														0.00
3														0.00
4														0.00

	Please include a detailed explanation (and additional documentation, if neccesary) to justify the additional need of allowances. §84.31(h)(1)(viii)







	Section 6 - Contracting Information
	Instructions: If the company is contracting out the manufacturing of defense sprays or metered dose inhalers, or paying another person (whether it is in cash, credit, goods, or services) to perform the servicing of onboard aerospace fire suppression, complete the following information for the contact doing to manufacturing or servicing:

	Manufacturing/Serviving Representative
	1	2	3	4	5	6	7
	Company Name §84.31(h)(1)(ix)	Contact Name §84.31(h)(1)(ix)	Contact Email §84.31(h)(1)(ix)	Contact Address §84.31(h)(1)(ix)	Contract City §84.31(h)(1)(ix)	Contact State §84.31(h)(1)(ix)	Contact Zip §84.31(h)(1)(ix)


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	Provide clarification on whether the responses in this report apply to the company that is allocated application-specific allowances or the company receiving the contract for manufacturing and/or servicing using application-specific allowances: §84.31(h)(1)(ix)

Sheet 3: Lists

Chemical Name

[Common Name]

[Common_Name_1]

[Common_Name_2]

[Common_Name_5]

[CASRN]

[Period]

[Month]

[Year]

[State]

CHF3

HFC-23

75-46-7

January 1 - June 30

January

2022

Alabama

CH2F2

HFC-32

75-10-5

July 1 - December 31

February

2023

Alaska

CH3F

HFC-41

593-53-3

March

2024

American Samoa

CF3CHFCHFCF2CF3

HFC-43-10mee

138495-42-8

April

2025

Arizona

CHF2CF3

HFC-125

354-33-6

May

2026

Arkansas

CHF2CHF2

HFC-134

359-35-3

June

2027

California

CH2FCF3

HFC-134a

811-97-2

July

2028

Colorado

CH2FCHF2

HFC-143

430-66-0

August

2029

Connecticut

CH3CF3

HFC-143a

420-46-2

September

2030

Delaware

CH2FCH2F

HFC-152

624-72-6

October

District of Columbia

CH3CHF2

HFC-152a

75-37-6

November

Florida

CF3CHFCF3

HFC-227ea

431-89-0

December

Georgia

CH2FCF2CF3

HFC-236cb

677-56-5

Guam

CHF2CHFCF3

HFC-236ea

431-63-0

Hawaii

CF3CH2CF3

HFC-236fa

690-39-1

Idaho

CH2FCF2CHF2

HFC-245ca

1814-88-6

Illinois

CF3CH2CF3

HFC-245fa

460-73-1

Indiana

CF3CH2CF2CH3

HFC-365mfc

406-58-6

Iowa

Kansas

[Option 1]

Kentucky

Yes

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Northern Mariana Islands

Ohio

Oklahoma

Oregon

Pennsylvania

Pueto Rico

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Washington

West Virginia

Wisconsin

Wyoming

U.S. Virgin Islands

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