5900-552 HFC International Transfers Reporting Form

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Overview

Company Information
Transfer Information
Lists

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Sheet 1: Company Information

				OMB Control Number: 2060-XXXX
				Expiration Date: X/XX/202X
	American Innovation and Manufacturing Act - HFC International Transfers Reporting Form
	Worksheet Instructions:
	Version:
	r0.1
	Updated:
	9/24/2021
	External Links:
	Reporting Form Navigation:
	Section 1 - Company Identification
	Section 2 - Foreign Country Contact Information
	Section 3 - Transaction Data
	Section 1 - Company Identification
	Instructions: Complete the following facility information.
	Company Name:
	AIMRS Company ID:
	Reporting Year:
	Is this a Request to Transfer Production Allowances from a Person in a Foreign Country?
	Is this a Request to Transfer Production Allowances to a Person in a Foreign Country?
	Section 2 - Foreign Country Contact Information
	Instructions: 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 HFCs 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 HFCs 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 HFCs 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 HFCs 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 Information
	1	2	3	4
	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 §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)
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	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 84.19). 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 6 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 # 5900-552

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Sheet 2: Transfer Information

			OMB Control Number: 2060-XXXX
			Expiration Date: X/XX/202X
	American Innovation and Manufacturing Act - HFC International Transfers Reporting Form
	Worksheet Instructions:
	Version:
	r0.1
	Updated:
	9/24/2021
	External Links:
	Reporting Form Navigation:
	Section 1 - Company Identification
	Section 2 - Foreign Country Contact Information
	Section 3 - Transaction Data
	Section 3 - Transaction Data
	Instructions: Provide information 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)).
	Transfer Request
	1	2	3
	Transaction Number	HFC §84.19(b)(2)(ii)(D) or §84.19(b)(3)(iv)	Quantity of Production Allowances Being Transferred (kg) §84.19(b)(2)(ii)(D) or §84.19(b)(3)(iv)
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2
3
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5

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Sheet 3: Lists

Chemical Name	[Common Name]		[Common_Name_1]		[Year]		[County]
CHF3	HFC-23	2	HFC-23		2023		Afghanistan
CH2F2	HFC-32	3	HFC-32		2024		Albania
CH3F	HFC-41	4	HFC-41		2025		Algeria
CF3CHFCHFCF2CF3	HFC-43-10mee	5	HFC-43-10mee		2026		Andorra
CHF2CF3	HFC-125	6	HFC-125		2027		Angola
CHF2CHF2	HFC-134	7	HFC-134		2028		Antigua and Barbuda
CH2FCF3	HFC-134a	8	HFC-134a		2029		Argentina
CH2FCHF2	HFC-143	9	HFC-143		2030		Armenia
CH3CF3	HFC-143a	10	HFC-143a				Australia
CH2FCH2F	HFC-152	11	HFC-152				Austria
CH3CHF2	HFC-152a	12	HFC-152a				Azerbaijan
CF3CHFCF3	HFC-227ea	13	HFC-227ea				Bahamas
CH2FCF2CF3	HFC-236cb	14	HFC-236cb				Bahrain
CHF2CHFCF3	HFC-236ea	15	HFC-236ea				Bangladesh
CF3CH2CF3	HFC-236fa	16	HFC-236fa				Barbados
CH2FCF2CHF2	HFC-245ca	17	HFC-245ca				Belarus
CF3CH2CF3	HFC-245fa	18	HFC-245fa				Belgium
CF3CH2CF2CH3	HFC-365mfc	19	HFC-365mfc				Belize
							Benin
[Option 1]							Bhutan
Yes							Bolivia
No							Bosnia and Herzegovina
							Botswana
							Brazil
							Brunei
							Bulgaria
							Burkina Faso
							Burundi
							Côte d'Ivoire
							Cabo Verde
							Cambodia
							Cameroon
							Canada
							Central African Republic
							Chad
							Chile
							China
							Colombia
							Comoros
							Congo (Congo-Brazzaville)
							Costa Rica
							Croatia
							Cuba
							Cyprus
							Czechia (Czech Republic)
							Democratic Republic of the Congo
							Denmark
							Djibouti
							Dominica
							Dominican Republic
							Ecuador
							Egypt
							El Salvador
							Equatorial Guinea
							Eritrea
							Estonia
							Eswatini (fmr. "Swaziland")
							Ethiopia
							Fiji
							Finland
							France
							Gabon
							Gambia
							Georgia
							Germany
							Ghana
							Greece
							Grenada
							Guatemala
							Guinea
							Guinea-Bissau
							Guyana
							Haiti
							Holy See
							Honduras
							Hungary
							Iceland
							India
							Indonesia
							Iran
							Iraq
							Ireland
							Israel
							Italy
							Jamaica
							Japan
							Jordan
							Kazakhstan
							Kenya
							Kiribati
							Kuwait
							Kyrgyzstan
							Laos
							Latvia
							Lebanon
							Lesotho
							Liberia
							Libya
							Liechtenstein
							Lithuania
							Luxembourg
							Madagascar
							Malawi
							Malaysia
							Maldives
							Mali
							Malta
							Marshall Islands
							Mauritania
							Mauritius
							Mexico
							Micronesia
							Moldova
							Monaco
							Mongolia
							Montenegro
							Morocco
							Mozambique
							Myanmar (formerly Burma)
							Namibia
							Nauru
							Nepal
							Netherlands
							New Zealand
							Nicaragua
							Niger
							Nigeria
							North Korea
							North Macedonia
							Norway
							Oman
							Pakistan
							Palau
							Palestine State
							Panama
							Papua New Guinea
							Paraguay
							Peru
							Philippines
							Poland
							Portugal
							Qatar
							Romania
							Russia
							Rwanda
							Saint Kitts and Nevis
							Saint Lucia
							Saint Vincent and the Grenadines
							Samoa
							San Marino
							Sao Tome and Principe
							Saudi Arabia
							Senegal
							Serbia
							Seychelles
							Sierra Leone
							Singapore
							Slovakia
							Slovenia
							Solomon Islands
							Somalia
							South Africa
							South Korea
							South Sudan
							Spain
							Sri Lanka
							Sudan
							Suriname
							Sweden
							Switzerland
							Syria
							Tajikistan
							Tanzania
							Thailand
							Timor-Leste
							Togo
							Tonga
							Trinidad and Tobago
							Tunisia
							Turkey
							Turkmenistan
							Tuvalu
							Uganda
							Ukraine
							United Arab Emirates
							United Kingdom
							United States of America
							Uruguay
							Uzbekistan
							Vanuatu
							Venezuela
							Vietnam
							Yemen
							Zambia
							Zimbabwe