HFC Transhipment Notification

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American Innovation and Manufacturing Act - HFC Transhipment Notification

Worksheet Instructions:
Complete this reporting form if your company has or intends to tranship HFCs through the United States. To notify EPA of a shipm
imported into the United States as a transhipment, complete Section 2. To notify EPA that the shipment was exported out of the U
complete Section 3. This form may only be used to notify EPA of either an upcoming import or a completed export.
Version:
r0.2
Updated:
12/9/2021
External Links:
HFC Allocation Rule Reporting HelpDesk
AIM Act Paperwork Reduction Act Burden
Reporting Form Navigation:
Section 1 - Company Identification
Section 3 - Export Information
Section 2 - Import Information

EPA may request additional information or ask follow up questions to verify the accuracy of this submission and suppor
documentation, including pursuant to CAA section 114 as authorized under the AIM Act.

Section 1 - Company Identification
Instructions: Complete the following company information.
Company Name:
Company ID:
Importer Number:
Is this a notification of a transhipment
being imported into the United States or
exported out of the United States?

Section 2 - Import Information

Instructions: Provide the following information for each shipment of an HFC that is to be transhipped through the United
working days before the shipment is to leave the foreign port of export for importation into the United States as a transhi
Transhipment Import Information
1
2
3
Vessel Name
Expected Year of Import
Expected Month of Import
§84.31(c)(3)(i)(D)
§84.31(c)(3)(i)(D)
§84.31(c)(3)(i)(D)

1

HFC Transhipment Information
2

HFC to be Transhipped
§84.31(c)(3)(i)(A)

HTS Code
§84.31(c)(3)(i)(A)

1
2
3
4
5

Section 3 - Export Information
Instructions: Provide the following information for each shipment of an
HFC that has been transhipped when it is exported from the United
States. The notification is required at least 10 working days after the
shipment is exported from the United States.

3
Quantity Transhipped
(kg)
§84.31(c)(3)(i)(A)

Transhipment Export Information
1
2
Vessel Name
Date of Export
§84.31(c)(3)(ii)(C)
§84.31(c)(3)(ii)(C)

1
HFC to be Transhipped
§84.31(c)(3)(ii)(A)

HFC Transhipment Information
2
HTS Code
§84.31(c)(3)(ii)(A)

3
Quantity Transhipped
(kg)
§84.31(c)(3)(ii)(A)

1
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.
information are mandatory (40 CFR 84.31). An agency may not conduct or sponsor, and a person is not required to respond to, a
currently valid OMB control number. The public reporting and recordkeeping burden for this collection of information is estimated t
the Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing
automated collection techniques to the Director, Regulatory Support Division, U.S. Environmental Protection Agency (2821T), 120
20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.
EPA Form # 5900-555

OMB Control Number: 2060-0735
Expiration Date: 4/30/2022

Notification

es. To notify EPA of a shipment that will be
nt was exported out of the United States,
leted export.

s submission and supporting

hipped through the United States. The notification is required at least 30
United States as a transhipment.
ation
4
5
Intended Port of Entry
Source Country
§84.31(c)(3)(i)(D)
§84.31(c)(3)(i)(C)

1 et seq. (OMB Control No. 2060-0735). Responses to this collection of
ot required to respond to, a collection of information unless it displays a
of information is estimated to be 1 hour per response. Send comments on
ted methods for minimizing respondent burden including through the use of
ection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C.
is address.