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Instructions for Form 8933

Department of the Treasury
Internal Revenue Service

(Rev. December 2022)

Carbon Oxide Sequestration Credit
Section references are to the Internal Revenue Code
unless otherwise noted.

Continuous-use form. Form 8933 will no longer be
updated annually. Instead, it will only be updated when
necessary.

Future Developments

For the latest information about developments related to
Form 8933 and its instructions, such as legislation
enacted after they were published, go to IRS.gov/
Form8933.

What’s New
Inflation Reduction Act. A summary of major changes
to section 45Q is as follows. Also see PL 117-169, sec.
13104 and sec. 13801.
• Extended the deadline to begin construction of qualified
facility from 2026 to 2033.
• Changed base rate for section 45Q(b)(1)(A)(i)(I) and (ll)
rates to $17 and $12 ($85 and $60 if section 45Q(h)(2)
requirements are met), respectively, for tax years
beginning after 2022.
• Changed base rate for section 45Q(b)(1)(B)(i) and (ii)
rates to $36 and $26 ($180 and $130 if section 45Q(h)(2)
requirements are met), respectively, for direct air capture
facilities, for tax years beginning after 2022.
• Reduced annual thresholds of capture carbon oxide for
qualified electric generating facility, qualified direct air
capture facility, and any other facility. See Qualified
facility.
• Changed credit reduction percentage to 15%. See
Coordination With Section 142 Bond Financing.
• Added definitions for new terms including Applicable
electric generating unit, Baseline carbon oxide production,
and Capacity factor.
• Section 45Q(f)(9) election for carbon oxide captured
and disposed of after 2021 for qualified facility located in a
federally declared disaster area for carbon oxide captured
and disposed of after 2021. See Section 45Q(f)(9)
Election.
• For prevailing wage and apprenticeship requirements,
regulations and guidance are pending. See Prevailing
Wage Requirements and Apprenticeship Requirements.
• For additional payment options over credits, regulations
and guidance are pending. See Elective Payment of
Applicable Credits and Transfer of Carbon Oxide
Sequestration Credits.
Credit rates and applicable dollar amounts. The
credit rates for lines 1b, 2b, and 3b are adjusted for
inflation and increased, per Notice 2022-XX. The
applicable dollar amounts for lines 4b, 5b, and 6b are
established by linear interpolation between statutory dollar
amounts and increased, per Notice 2018-93. See 2022
credit rates and applicable dollar amounts.

Oct 04, 2022

Section 45Q(f)(3)(B) election. Line 13 and its
instructions are expanded to include the individual listing
of the three largest elections (in dollars) given to you by
another person(s). See Line 13. Section 45Q(f)(3)(B)
Election, later.

Reminder
Credit reduced for certain tax-exempt bonds. The
Infrastructure Investment and Jobs Act provides that a
section 45Q project can be financed with tax-exempt
section 142 bonds issued after December 31, 2021, but
this will reduce any carbon oxide sequestration credit
arising from the project. See Coordination With Section
142 Bond Financing, later.

General Instructions
Purpose of Form

Use Form 8933 to claim the section 45Q carbon oxide
sequestration credit. See Definitions, later.
For purposes of this form, a partner in a partnership
that has made a valid section 761(a) election will be
considered the taxpayer. Partnerships with valid section
761(a) elections aren’t required to complete or file this
form. Instead, the partner is required to complete and file
this form in a manner commensurate with its undivided
ownership interest in the qualified facility. Also, see Rev.
Proc. 2020-12, 2020-11, I.R.B. 511, for allocation safe
harbor.
However, if you elect to use the TD, the section 761(a)
election applies only in the case of qualified carbon oxide
captured using carbon capture equipment that's originally
placed in service at a qualified facility before February 9,
2018. For qualified carbon oxide captured using carbon
capture equipment that's originally placed in service at a
qualified facility on or after February 9, 2018, for each
single process train of carbon capture equipment (as
described in Regulations section 1.45Q-2(c)(3)), only one
taxpayer will be considered the person to whom the credit
is attributable and only that person may claim the carbon
oxide sequestration credit. See Regulations section
1.45Q-1(h)(1).
Taxpayers other than partnerships or S corporations
whose only source of this credit is from those
pass-through entities (other than a partnership with a valid
761(a) election) aren’t required to complete or file this
form. Instead, report this credit directly on line 1x in Part III
of Form 3800, General Business Credit.

Cat. No. 74390F

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• Line 2b: $12.53 per metric ton.
• Line 3b: $12.53 per metric ton.

How To Figure the Credit

Subject to the section 45Q(f)(3)(B) election (discussed
later), section 45Q(a)(1) allows a credit of $20 per metric
ton of qualified carbon oxide captured by you using
carbon capture equipment that is (1) originally placed in
service at a qualified facility before February 9, 2018, (2)
disposed of by you in secure geological storage, and (3)
not used by you as a tertiary injectant in a qualified
enhanced oil recovery (EOR) or natural gas recovery
project or utilized by you in a manner described in section
45Q(f)(5).

For any tax year beginning in a calendar year after
2016 and before 2027, the section 45Q(b)(1)(A)
applicable dollar amounts for lines 4b, 5b, and 6b are
established by linear interpolation between $22.66 and
$50, and $12.83 and $35, respectively. The applicable
dollar amounts are as follows.
• Line 4b: $37.85 per metric ton.
• Line 5b: $25.15 per metric ton.
• Line 6b: $25.15 per metric ton.
After 2022, the applicable dollar amounts are as
follows.
• Line 4b: $17 per metric ton ($85 per metric ton if section
45Q(h)(2) requirements are met).
• Line 5b: $12 per metric ton ($60 per metric ton if section
45Q(h)(2) requirements are met).
• Line 6b: $12 per metric ton ($60 per metric ton if section
45Q(h)(2) requirements are met).
For direct air capture facilities placed in service after
2022, the section 45Q(b)(1)(B) applicable dollar amounts
are as follows.
• Line 7b: $36 per metric ton ($180 per metric ton if
section 45Q(h)(2) requirements are met).
• Line 8b: $26 per metric ton ($130 per metric ton if
section 45Q(h)(2) requirements are met).
• Line 9b: $26 per metric ton ($130 per metric ton if
section 45Q(h)(2) requirements are met).
See Notice 2022-XX, 2022-XX I.R.B. XXX, available at
IRS.gov/irb/2021-46_IRB#NOT-2021-35 and Notice
2018-93, 2018-51 I.R.B. 1041, available at IRS.gov/irb/
2018-51_IRB#NOT-2018-93.

Section 45Q(a)(2) allows a credit of $10 per metric ton
of qualified carbon oxide (1) captured by you using carbon
capture equipment that is originally placed in service at a
qualified facility before February 9, 2018; and (2) either (a)
used by you as a tertiary injectant in a qualified EOR or
natural gas recovery project and disposed of by you in
secure geological storage, or (b) utilized by you in a
manner described in section 45Q(f)(5).
Section 45Q(a)(3) allows a credit of the applicable
dollar amount (as determined under section 45Q(b)(1))
per metric ton of qualified carbon oxide (1) captured by
you using carbon capture equipment that is originally
placed in service at a qualified facility on or after February
9, 2018, during the 12-year period beginning on the date
the equipment was originally placed in service, (2)
disposed of by you in secure geological storage, and (3)
neither used as a tertiary injectant in a qualified EOR or
natural gas recovery project nor utilized in a manner
described in section 45Q(f)(5).
Section 45Q(a)(4) allows a credit of the applicable
dollar amount (as determined under section 45Q(b)(1))
per metric ton of qualified carbon oxide (1) captured by
you using carbon capture equipment that is originally
placed in service at a qualified facility on or after February
9, 2018, during the 12-year period beginning on the date
the equipment was originally placed in service; and (2)
either (a) used by you as a tertiary injectant in a qualified
EOR or natural gas recovery project and disposed of by
you in secure geological storage, or (b) utilized in a
manner described in section 45Q(f)(5).

Amount captured by additional carbon capture
equipment on existing qualified facility. For a
qualified facility placed in service before February 9, 2018,
for which additional carbon capture equipment is placed in
service on or after February 9, 2018, the amount of
qualified carbon oxide that is captured by you is the
following.
• For purposes of lines 1, 2, and 3, equal to the lesser of
(a) the total amount of qualified carbon oxide captured at
such facility for the tax year, or (b) the total amount of the
carbon dioxide capture capacity of the carbon capture
equipment in service at such facility on the day before
February 9, 2018.
• For purposes of lines 4, 5, and 6, an amount (not less
than zero) equal to the excess of (a) the total amount of
qualified carbon oxide captured at such facility for the tax
year, over (b) the total amount of the carbon dioxide
capture capacity of the carbon capture equipment in
service at such facility on the day before February 9,
2018.

For purposes of determining the credit, you may elect
under section 45Q(b)(3) to have the dollar amounts
applicable under section 45Q(a)(1) or (2) apply in lieu of
the dollar amounts applicable under section 45Q(a)(3) or
(4) for each metric ton of qualified carbon oxide that is
captured by you using carbon capture equipment that is
originally placed in service at a qualified facility on or after
February 9, 2018.
For the purpose of calculating the credit, a metric ton of
carbon oxide includes only the contained weight of the
carbon oxide. The weight of any other substances, such
as water or impurities, isn’t included in the calculation.

Definitions
Qualified carbon oxide. This is (a) any carbon dioxide
captured from an industrial source by carbon capture
equipment originally placed in service before February 9,
2018, which would otherwise be released into the
atmosphere as industrial emission of greenhouse gas or

2022 credit rates and applicable dollar amounts. The
credit rates for lines 1b, 2b, and 3b are increased by the
adjustment for inflation. The rates are as follows.
• Line 1b: $25.07 per metric ton.
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lead to such release, and is measured at the source of
capture and verified at the point of disposal, injection, or
utilization; (b) any carbon dioxide or other carbon oxide
that is captured from an industrial source by carbon
capture equipment originally placed in service on or after
February 9, 2018, which would otherwise be released into
the atmosphere as industrial emission of greenhouse gas
or lead to such release, and is measured at the source of
capture and verified at the point of disposal, injection, or
utilization; or (c) in the case of a direct air capture facility,
any carbon dioxide that is captured directly from the
ambient air, and is measured at the source of capture and
verified at the point of disposal, injection, or utilization.
Qualified carbon oxide includes the initial deposit of
captured carbon oxide used as a tertiary injectant. It
doesn’t include carbon oxide that’s recaptured, recycled,
and re-injected as part of the EOR and natural gas
recovery process.

production during the 12-year period preceding the date
on which construction of such equipment began; or
• In the case of an applicable electric generating unit that
(i) as of the date on which construction of the carbon
capture equipment begins, is not yet placed in service; or
(ii) was placed in service during the 1-year period prior to
the date on which construction of the carbon capture
equipment begins, the designed annual carbon oxide
production, by mass, as determined based on an
assumed capacity factor of 60%.
Capacity factor. Capacity factor means the ratio
(expressed as a percentage) of the actual electric output
from the applicable electric generating unit to the potential
electric output from such unit.
Industrial facility. An industrial facility is a facility that
produces a carbon oxide stream from a fuel combustion
source or fuel cell, a manufacturing process, or a fugitive
carbon oxide emission source that, absent capture and
disposal, would otherwise be released into the
atmosphere as industrial emission of greenhouse gas or
lead to such release. An industrial facility doesn’t include
a facility that produces carbon dioxide from carbon
dioxide production wells at natural carbon dioxide-bearing
formations or a naturally occurring subsurface spring.
Depending on your election to use the NPRM or the TD,
see section 3.02(b) of Notice 2009-83 or Proposed
Regulations section 1.45Q-2(d)(1) or Regulations section
1.45Q-2(d)(1) and (d)(2). An Industrial Source is an
emission of carbon oxide from an industrial facility. A
Manufacturing Process is a process involving the
manufacture of products, other than carbon oxide, that are
intended to be sold at a profit, or are used for a
commercial purpose. All facts and circumstances with
respect to the process and products are to be taken into
account.

Carbon capture equipment. This includes all
components of property that are used to capture or
process carbon oxide until the carbon oxide is transported
for disposal, injection, or utilization. Carbon capture
equipment is equipment used for the purpose of (1)
separating, purifying, drying, and/or capturing carbon
oxide that would otherwise be released into the
atmosphere from an industrial facility; (2) removing carbon
oxide from the atmosphere via direct air capture; or (3)
compressing or otherwise increasing the pressure of
carbon oxide.
All components that make up an independently
functioning process train capable of capturing,
processing, and preparing carbon oxide for transport will
be treated as a single unit of carbon capture equipment
(single process train). See Rev. Rul. 2021-13, 2021-30
I.R.B. 152, available at IRS.gov/irb/2021-30_IRB#REVRUL-2021-13.

Electricity generating facility. An electricity generating
facility is a facility described in section 45Q(d)(2)(A) or (B)
and is subject to depreciation under MACRS asset class
49.11 (Electric Utility Hydraulic Production Plant), 49.12
(Electric Utility Nuclear Production Plant), 49.13 (Electric
Utility Steam Production Plant), or 49.15 (Electric Utility
Combustion Turbine Production Plant).

Applicable electric generating unit. An applicable
electric generating unit is the principal electric generating
unit for which the carbon capture equipment is originally
planned and designed.
Baseline carbon oxide production. A baseline carbon
oxide production means either of the following.
• In the case of an applicable electric generating unit that
was originally placed in service more than 1 year prior to
the date on which construction of the carbon capture
equipment begins, the average annual carbon oxide
production, by mass, from such unit during (i) in the case
of an applicable electric generating unit that was originally
placed in service more than 1 year prior to the date on
which construction of the carbon capture equipment
begins and on or after the date that is 3 years prior to the
date on which construction of such equipment begins, the
period beginning on the date such unit was placed in
service and ending on the date on which construction of
such equipment began; and (ii) in the case of an
applicable electric generating unit that was originally
placed in service more than 3 years prior to the date on
which construction of the carbon capture equipment
begins, the 3 years with the highest annual carbon oxide
Instructions for Form 8933 (Rev. 12-2022)

Direct air capture facility. A direct air capture facility
means any facility that uses carbon capture equipment to
capture carbon oxide directly from the ambient air. It
doesn’t include any facility that captures carbon dioxide
(1) that is deliberately released from naturally occurring
subsurface springs, or (2) using natural photosynthesis.
Qualified facility. Any industrial facility or direct air
capture facility (a) the construction of which begins before
January 1, 2033, and the construction of carbon capture
equipment begins before that date, or the original
planning and design for the facility includes installation of
carbon capture equipment; and (b) which captures:
1. In the case of a direct air capture facility, captures
not less than 1,000 metric tons of qualified carbon oxide
during the tax year;

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2. In the case of an electricity generating facility that (i)
captures not less than 18,750 metric tons of qualified
carbon oxide during the tax year; and (ii) with respect to
any carbon capture equipment for the applicable electric
generating unit at such facility, has a capture design
capacity of not less than 75% of the baseline carbon oxide
production of such unit; or
3. In the case of any other facility, captures not less
than 12,500 metric tons of qualified carbon oxide during
the tax year.

If you are claiming a credit for a facility that was placed
in service in tax years beginning on or after February 9,
2018, qualified carbon oxide is considered disposed of by
you in secure geological storage such that the qualified
carbon oxide doesn’t escape into the atmosphere if the
qualified carbon oxide is:
• Stored, and not used as a tertiary injectant in a qualified
EOR or natural gas recovery project, in compliance with
applicable requirements under 40 CFR Part 98 subpart
RR;
• Used as a tertiary injectant in a qualified EOR or natural
gas recovery project and stored in compliance with
applicable requirements under 40 CFR Part 98 subpart
RR, or the International Organization for Standardization
(ISO) Standards endorsed by the American National
Standards Institute (ANSI) under CSA/ANSI ISO
27916:19, Carbon dioxide capture, transportation and
geological storage—Carbon dioxide storage using
enhanced oil recovery (CO2-EOR); and
• Injected into a well that complies with applicable
Underground Injection Control regulations onshore or
offshore under submerged lands within the territorial
jurisdiction of the United States.

Qualified EOR or natural gas recovery project. A
qualified EOR or natural gas recovery project means any
project located in the United States involving the
application of one or more tertiary recovery methods
defined in section 193(b)(3) that can reasonably be
expected to result in more than an insignificant increase in
the amount of crude oil or natural gas that will ultimately
be recovered and with respect to which the first injection
of liquids, gases, or other matter begins after 1990.
Natural gas. Natural gas means any product (other than
crude oil) of an oil or gas well if a deduction for depletion
is allowable under section 611 with respect to such
product.

Utilization of qualified carbon oxide. Utilization of
qualified carbon oxide means (1) the fixation of such
qualified carbon oxide through photosynthesis or
chemosynthesis, such as through the growing of algae or
bacteria; (2) the chemical conversion of such qualified
carbon oxide to a material or chemical compound in which
such qualified carbon oxide is securely stored; or (3) the
use of such qualified carbon oxide for any other purpose
for which a commercial market exists (with the exception
of use as a tertiary injectant in a qualified EOR or natural
gas recovery project), as determined by the Secretary of
the Treasury or his delegate.

Tertiary injectant. An injectant (other than a
hydrocarbon injectant that is recoverable) that is used as
part of a tertiary recovery method. For more details, see
section 193(b).
Secure geological storage. Secure geological storage
includes, but isn’t limited to, storage at deep saline
formations, oil and gas reservoirs, and unminable coal
seams.
If you are claiming a credit for a facility placed in
service before February 9, 2018, the following applies.
• Secure geological storage requires approval by the
U.S. Environmental Protection Agency (EPA) of a
Monitoring, Reporting, and Verification Plan (MRV Plan)
submitted by the operator of the storage facility or tertiary
injection project.
• The annual amount of carbon oxide claimed for the
credit must be consistent with amounts reported to the
EPA under its Greenhouse Gas Reporting Program,
subpart RR.
See sections 6 through 8 of Notice 2009-83, 2009-44
I.R.B. 588, available at IRS.gov/irb/
2009-44_IRB#NOT-2009-83 for reporting and
recordkeeping requirements associated with the limitation
on credits available under former section 45Q(a) (as in
effect before February 9, 2018) and sections 45Q(a)(1)
and (2). Sections 1 through 5 of Notice 2009-83 were
obsoleted by REG-112339-19, 85 F.R. 34050-34075.
After the end of the calendar year in which the Secretary,
in consultation with the Administrator of the EPA, certifies
that a total of 75,000,000 metric tons of qualified carbon
oxide have been taken into account under former section
45Q(a) (as in effect before February 9, 2018) and sections
45Q(a)(1) and (2), the remaining sections of Notice
2009-83 will be obsoleted.

United States and U.S. possessions. This includes the
seabed and subsoil of those submarine areas that are
adjacent to the territorial waters of the United States (or a
U.S. possession) and over which the United States has
exclusive rights, in accordance with international law, with
respect to the exploration and exploitation of natural
resources.

Who Can Claim the Credit

The credit is attributable to you in the case of qualified
carbon oxide captured using carbon capture equipment
that is originally placed in service at a qualified facility on
or after February 9, 2018, if you’re the person that owns
the carbon capture equipment and physically or
contractually ensures the disposal, utilization, or use as a
tertiary injectant of this qualified carbon oxide.

Elections
Section 45Q(b)(3) Election

You can elect to have the credit rates applicable to lines
1b, 2b, and 3b apply instead of the applicable dollar
amounts applicable to lines 4b, 5b, and 6b for each metric
ton of qualified carbon oxide that is captured by you using

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carbon capture equipment that is originally placed in
service at a qualified facility on or after February 9, 2018.

ELECT, later, and the information below) with the Form
8933 no later than the time prescribed by law (including
extensions) for filing your federal income tax return or
Form 1065 for the year in which the credit arises. You
must make a separate election for each qualified facility.

Section 45Q(f)(6) Election

For purposes of section 45Q, for any tax year in which
such facility is an applicable facility (a facility placed in
service before February 9, 2018, and for which no
taxpayer claimed a carbon oxide sequestration credit for
any tax year ending before February 9, 2018) that
captures not less than 500,000 metric tons of qualified
carbon oxide during the tax year, you can elect to have
the facility, and any carbon capture equipment placed in
service at the facility, treated as placed in service on
February 9, 2018.

The election may not be filed with an amended
federal income tax return, an amended Form
CAUTION 1065, or an Administrative Adjustment Request
(AAR), as applicable, after the prescribed date (including
extensions) for filing the original federal income tax return
or Form 1065 for the year, with the exception of amended
federal income tax returns, amended Forms 1065, or
AARs, as applicable, for any tax year ending after
February 9, 2018, and beginning on or before January 13,
2021. The amended federal income tax return or the
amended Form 1065 must be filed, in no event, later than
the applicable period of limitations on assessment for the
tax year for which the amended federal income tax return
or Form 1065 is being filed.

!

You make a section 45Q(f)(6) election by filing a
statement of election with your income tax return for each
tax year in which the credit arises. In addition to any
information required on Form 8933, your statement of
election must show your name, address, taxpayer
identification number, location, and the identification
number(s) assigned to the facility by the EPA's electronic
Greenhouse Gas Reporting Tool (e-GGRT ID number(s))
(if available).

Information required to be provided by electing taxpayer.
• Election statement of the electing taxpayer on Form
8933 must indicate that an election is being made under
section 45Q(f)(3)(B);
• The electing taxpayer must provide each credit
claimant with a copy of the electing taxpayer’s Form 8933;
and
• The electing taxpayer must, in addition to any
information required on Form 8933, set forth the following
information.
1. The electing taxpayer’s name, address, taxpayer
identification number, location, and e-GGRT ID number(s)
(if available) of each qualified facility where carbon oxide
was captured;
2. The full amount of credit attributable to the taxpayer
prior to the election;
3. The name, address, and taxpayer identification
number of each credit claimant, and the location and EPA
e-GGRT ID number(s) (if available) of each secure
geological storage facility where the qualified carbon
oxide is disposed of or injected;
4. The dollar amount of credits the taxpayer is allowing
each credit claimant to claim and the corresponding
metric tons of qualified carbon oxide; and
5. The dollar amount of credits retained by the electing
taxpayer and the corresponding metric tons of qualified
carbon oxide.

Note. EPA e-GGRT ID number(s) are identification
number(s) assigned to the facility by the EPA's electronic
Greenhouse Gas Reporting Tool.

Section 45Q(f)(3)(B) Election

In the case of qualified carbon oxide captured using
carbon capture equipment that is originally placed in
service at a qualified facility before February 9, 2018, if
you’re the person that captures and physically or
contractually ensures the disposal, injection, or utilization
of the qualified carbon oxide, the credit is attributable to
you. You may claim the credit, or you may elect to allow
the credit to the person that disposes of, injects, or utilizes
the qualified carbon oxide. If you make this election, the
amount you elect to allow won’t be allowed to you. You
can also elect to allow only part of the credit to the person
that disposes of, injects, or utilizes the qualified carbon
oxide in a tax year, and to claim the remainder yourself.
In the case of qualified carbon oxide captured using
carbon capture equipment that is originally placed in
service at a qualified facility on or after February 9, 2018, if
you’re the person that owns the carbon capture
equipment and physically or contractually ensures the
capture and disposal, utilization, or use as a tertiary
injectant of such carbon oxide, you may check the box to
elect to allow the credit to another person that disposes
of, injects, or utilizes the qualified carbon oxide. If you
make this election, the amount you elect to allow won’t be
allowed to you. You can also elect to allow only part of the
credit to the person that disposes of, injects, or utilizes the
qualified carbon oxide in a tax year, and to the claim the
remainder yourself.

Information required to be provided by credit claimant. Credit claimant must include the following
information on Form 8933 with its timely filed federal
income tax return or Form 1065 (including extensions).
• The name, address, and taxpayer identification number
of the credit claimant;
• The name, address, and taxpayer identification number
of each taxpayer making an election under section 45Q(f)
(3)(B) to allow the credit to the credit claimant;

A new section 45Q(f)(3)(B) election must be made
annually. You make a section 45Q(f)(3)(B) election by
filing a statement of election (see Model Certificate
Instructions for Form 8933 (Rev. 12-2022)

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• The location and EPA e-GGRT ID number(s) (if
available) of each qualified facility where carbon oxide
was captured;
• The location and EPA e-GGRT ID number(s) (if
available) of each secure geological storage facility where
the qualified carbon oxide is disposed of or injected;
• The full dollar amount of credits attributable to each
electing taxpayer prior to the election and the
corresponding metric tons of carbon oxide;
• The dollar amount of credits that each electing taxpayer
is allowing the credit claimant to claim and the
corresponding metric tons of carbon oxide; and
• A copy of the electing taxpayer’s Form 8933.

1.461-1(a)(1) and (2)) five percent or more of the total cost
of a qualified facility or carbon capture equipment and
meets other requirements provided in section 6 of Notice
2020-12.
Although both methods can be used, only one method
is needed to establish that construction of a qualified
facility or carbon capture equipment has begun. If you
began construction on a qualified facility or carbon
capture equipment by satisfying either the Physical Work
Test or the Five Percent Safe Harbor Test, or both, before
the effective date of Notice 2020-12 (March 9, 2020), you
may use March 9, 2020, as the date that construction
began on such qualified facility or carbon capture
equipment. Additionally, if you began construction on a
qualified facility or carbon capture equipment before
March 9, 2020, under both the Physical Work Test and the
Five Percent Safe Harbor, you may choose either method
(but not both) for the purpose of applying the beginning of
construction rules. If you began construction on a qualified
facility or carbon capture equipment on or after March 9,
2020, construction will be deemed to have begun on the
date you first satisfy either the Physical Work Test or the
Five Percent Safe Harbor Test. If you fail to satisfy the
Five Percent Safe Harbor Test in one year due to cost
overruns (as defined in section 6.03 of Notice 2020-12),
you won’t be prevented from using the Physical Work Test
in a later year to establish beginning of construction,
provided that occurs before January 1, 2033.

Section 45Q(f)(9) Election

For purposes of section 45Q(a)(3) and (4), a person
described in section 45Q(f)(3)(A)(ii) may elect, at such
time and in such manner as the Secretary may prescribe,
to have the 12-year period begin on the first day of the first
tax year in which a credit under this section is claimed
with respect to carbon capture equipment that is originally
placed in service at a qualified facility on or after February
9, 2018, if:
• No one claimed a credit under this section with respect
to such carbon capture equipment for any prior tax year;
• The qualified facility at which such carbon capture
equipment is placed in service is located in an area
affected by a federally declared disaster (as defined by
section 165(i)(5)(A)) after the carbon capture equipment is
originally placed in service; and
• Such federally declared disaster results in a cessation
of the operation of the qualified facility or the carbon
capture equipment after such equipment is originally
placed in service.

Prevailing Wage Requirements

With respect to any qualified facility and any carbon
capture equipment placed in service at such facility, you
shall ensure that any laborers and mechanics employed
by the taxpayer or any contractor or subcontractor in (i)
the construction of such facility or equipment, and (ii) with
respect to any tax year, for any portion of such tax year
that is within the period described in section 45Q(a)(3)(A)
or (4)(A), the alteration or repair of such facility or such
equipment, shall be paid wages at rates not less than the
prevailing rates for construction, alteration, or repair of a
similar character in the locality in which such facility and
equipment are located as most recently determined by the
Secretary of Labor, in accordance with subchapter IV of
chapter 31 of title 40, United States Code. The new
requirements will apply to projects the construction of
which begins within 60 days on or after the date on which
regulatory guidance is issued regarding the new
requirements.

Application of Section 45Q for Certain
Carbon Capture Equipment

In the case of any carbon capture equipment placed in
service before February 9, 2018, the credit will apply to
qualified carbon oxide captured using such equipment
before the end of the calendar year in which the
Secretary, in consultation with the Administrator of the
EPA, certifies that, during the period beginning after
October 3, 2008, a total of 75,000,000 metric tons of
qualified carbon oxide have been taken into account in
accordance with section 45Q(a), as in effect on the day
before February 9, 2018, and section 45Q(a)(1) and (2).

When Construction Begins

Correction and penalty related to failure to satisfy
wage requirements. See section 45(b)(7)(B) for details.

Two methods can be used to establish that construction of
a qualified facility or carbon capture equipment has
begun.
1. Physical Work Test is satisfied when physical
work of a significant nature begins and other requirements
provided in section 5 of Notice 2020-12, 2020-11 I.R.B.
495, available at IRS.gov/irb/2020-11_IRB#NOT-2020-12,
are met.
2. Five Percent Safe Harbor is satisfied when you
pay or incur (within the meaning of Regulations section

Apprenticeship Requirements

The new requirements will apply to projects the
construction of which begins within 60 days on or after the
date on which regulatory guidance is issued regarding the
new requirements. See section 45(b)(8) for details.
Correction and penalty related to failure to satisfy
wage requirements. See section 45(b)(7)(B) for details.
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Recapture

the proceeds from an issue described in section 142(a)
(17) used to provide financing for the project the interest
on which is exempt from tax under section 103, and the
denominator of which is the aggregate amount of
additions to the capital account for the project for the tax
year and all prior tax years. The amounts under the
preceding sentence for any tax year are determined as of
the close of the tax year.

Qualified carbon oxide ceases to be captured,
disposed of, or used as a tertiary injectant if the leaked
amount of qualified carbon oxide in the tax year exceeds
the amount of qualified carbon oxide disposed of in
secure geological storage or used as a tertiary injectant in
that same tax year.

Note. For purposes of the above, there are no prior tax
years before January 1, 2022.

A recapture event occurs when qualified carbon oxide for
which a carbon oxide sequestration credit has been
claimed ceases to be captured, disposed of, or used as a
tertiary injectant during the recapture period. Recapture
events are determined separately for each project
involving capture, disposal, or use of qualified carbon
oxide as a tertiary injectant.

Reporting Requirements
General Requirements

If you are claiming the carbon oxide sequestration credit,
you must provide the name and location of the qualified
facilities at which the qualified carbon oxide was captured.

If a recapture event occurs during a project’s recapture
period and you have claimed a credit for that project, you
must report the following information on a Form 8933 filed
with your federal income tax return or Form 1065 for the
tax year for which the recapture event occurred.
• The recapture amount (as defined in Regulations
section 1.45Q-5(e));
• The quantity of leaked qualified carbon oxide (in metric
tons) (as defined in Regulations section 1.45Q-5(c));
• The statutory credit rate at which the credits were
originally calculated; and
• A statement that describes how you became aware of
the recapture event, how the leaked amount was
determined, and the identity and involvement of any
regulatory agencies.

If you are claiming the section 45Q credit on an
amended federal income tax return, an amended
CAUTION Form 1065, or an AAR, as applicable, you must
state “AMENDED RETURN FOR SECTION 45Q CREDIT”
at the top of the amended federal income tax return, the
amended Form 1065, or the AAR, as applicable. The
amended federal income tax return or the amended Form
1065 must be filed, in no event, later than the applicable
period of limitations on assessment for the tax year for
which the amended federal income tax return or Form
1065 is being filed.

!

Contractually Ensuring Disposal, Injection, or
Utilization of Qualified Carbon Oxide

Elective Payment of Applicable
Credits

If you enter into a contract with another party to ensure
disposal, injection, or utilization of qualified carbon oxide,
you must report the existence of each contract, and the
parties involved annually on Form 8933 by each party to
the contract, regardless of the party claiming the credit. In
addition to any information stated as required on Form
8933, the report must include the following information.
• Your name and identifying number;
• The name and taxpayer identification number of each
party with whom you have entered into a contract to
ensure the disposal, injection, or utilization of qualified
carbon oxide;
• The date on which each contract was executed;
• The number of metric tons of qualified carbon oxide
each contracting party disposes of, injects, or utilizes on
behalf of you each tax year for reporting to the IRS; and
• For contracts for the disposal of qualified carbon oxide
in secure geological storage or the use of qualified carbon
oxide as a tertiary injectant in EOR or natural gas
recovery, identifying information (the name of the
operator, field, unit, and reservoir), location by county and
state, and EPA e-GGRT ID number(s) (if available) for
submission of the facility’s 40 CFR Part 98 (subpart RR)
annual reports. For this reporting, use a statement
substantially similar to Model Certificate RECAPTURE.

For tax years beginning after 2022, you can elect under
section 6417 with respect to your carbon oxide
sequestration credit to be treated as making a payment
against the tax imposed by subtitle A (for the tax year with
respect to which the carbon oxide sequestration credit
was determined) equal to the amount of such credit. See
section 6417.

Transfer of Carbon Oxide
Sequestration Credits

For tax years beginning after 2022, you can elect under
section 6418 to transfer all (or any portion specified in the
election) of your carbon oxide sequestration credits to an
unrelated third party (transferee) for cash. The cash
payment received by you will not be treated as taxable
income, and the third party transferee may not deduct the
cash payment. Once a carbon oxide sequestration credit
is transferred to a third party under section 6418, the third
party may not transfer it again. See section 6418.

Coordination With Section 142 Bond
Financing

The credit for any project for any tax year is reduced by
the amount that is the product of the credit for such tax
year and the lesser of 15%, or a fraction, the numerator of
which is the sum, for the tax year and all prior tax years, of
Instructions for Form 8933 (Rev. 12-2022)

Secure Geological Storage

Certifications must be made annually.
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Qualified EOR or Natural Gas Recovery Project

Reporting Based on 40 CFR Part 98 (Subpart RR)

Each qualified EOR or natural gas recovery project must
be certified under Regulations section 1.43-3.

For an EOR or natural gas recovery project in which you
reported volumes to the EPA pursuant to 40 CFR Part 98
subpart RR, you may self-certify the volume of carbon
oxide claimed for purposes of the credit.

For purposes of a natural gas project, a petroleum
engineer's certification as required under Regulations
section 1.43-3(a)(3) and an operator's continued
certification of a project as required under Regulations
section 1.43-3(b)(3) must include an additional statement
that the certification is for purposes of the credit.

Reporting Based on CSA/ANSI ISO 27916:19
For an EOR or natural gas recovery project in which you
determined volumes pursuant to CSA/ANSI ISO
27916:19, you may prepare documentation as outlined in
CSA/ANSI ISO 27916:19 internally, but such
documentation must be provided to a qualified
independent engineer or geologist, who then must certify
that the documentation provided, including the mass
balance calculations as well as information regarding
monitoring and containment assurance, is accurate and
complete. For any leaked amount of qualified carbon
oxide that is determined pursuant to CSA/ANSI ISO
27916:19, the certification must also include a statement
that the quantity was determined in accordance with
sound engineering principles.

Petroleum Engineer’s Certification
The petroleum engineer's certification must be attached to
a Form 8933 and filed no later than the last date
prescribed by law (including extensions) for filing the
operator's or designated owner's federal income tax return
or Form 1065 for the first tax year in which qualified
carbon oxide is injected into the reservoir.
If a credit is claimed on an amended federal
income tax return, an amended Form 1065, or an
CAUTION AAR, as applicable, the petroleum engineer's
certification will be treated as filed timely if it is attached to
a Form 8933 that is submitted with such amended federal
income tax return, amended Form 1065, or AAR. With
respect to a credit that is claimed on a timely filed federal
income tax return or Form 1065 for a tax year ending after
February 9, 2018, and beginning on or before January 13,
2021, for which the petroleum engineer's certification
wasn’t submitted, the petroleum engineer's certification
will be treated as filed timely if it is attached to an
amended Form 8933 for any tax year ending after
February 9, 2018, but not for tax years beginning on or
before January 13, 2021.

!

If you capture qualified carbon oxide giving rise to the
credit, you must file Form 8933 with a timely filed federal
income tax return or Form 1065, including extensions, or
for the purpose of this rule, amendments to federal
income tax returns, Forms 1065, or on AARs, as
applicable. Similarly, if you dispose of, inject, or utilize
qualified carbon oxide, you must also file Form 8933 with
a timely filed federal income tax return or Form 1065,
including extensions, or for the purpose of this rule,
amendments to federal income tax returns, Forms 1065,
or on AARs, as applicable. If the volume of carbon oxide
certified and reported is a negative amount, see
Regulations section 1.45Q-5 for rules regarding
recapture.

Operator’s Continued Certification
The operator's continued certification of a project must be
attached to a Form 8933 and filed no later than the last
date prescribed by law (including extensions) for filing the
operator's or designated owner's federal income tax return
or Form 1065 for tax years after the tax year for which the
petroleum engineer's certification is filed but not after the
tax year in which injection activity ceases and all injection
wells are plugged and abandoned.

No credit is allowed for any tax year for which you
(including credit claimants) have failed to timely
CAUTION submit complete documentation, including the
required certifications. The credit will be allowed only for a
tax year for which complete documentation and
certification has been timely submitted. Certifications for
each tax year must be submitted by the due date of the
federal income tax return or Form 1065 on which the
credit is claimed, including extensions. If a credit is
claimed on an amended federal income tax return, an
amended Form 1065, or an AAR, as applicable,
certifications may also be submitted with such amended
federal income tax return, amended Form 1065, or AAR. If
a credit was claimed on a timely filed federal income tax
return or Form 1065 for a tax year ending after February 9,
2018, and beginning on or before January 13, 2021, for
which certifications weren’t submitted, such certifications
may be submitted with an amended federal income tax
return, an amended Form 1065, or an AAR, as applicable,
for the tax year in which the credit was claimed.

!

Utilization

The amount of qualified carbon oxide utilized by you is
equal to the metric tons of qualified carbon oxide that you
demonstrate, based upon an analysis of lifecycle
greenhouse gas emissions (LCA), that were captured and
permanently isolated from the atmosphere (isolated), or
displaced from being emitted into the atmosphere
(displaced).

Lifecycle greenhouse gas emissions and lifecycle
analysis. The term “lifecycle greenhouse gas emissions”
means the aggregate quantity of greenhouse gas
emissions (including direct emissions and significant
indirect emissions such as significant emissions from land
use changes) related to the full product lifecycle, including
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all stages of product and feedstock production and
distribution, from feedstock generation or extraction
through the distribution and delivery and use of the
finished product to the ultimate consumer, where the
mass values for all greenhouse gases are adjusted to
account for their relative global warming potential
according to Table A-1 of 40 CFR Part 98 subpart A. The
amount of lifecycle greenhouse gas emissions measured
by a lifecycle greenhouse gas analysis (LCA) is
expressed in carbon dioxide equivalents (CO2-e).

You should also send the DOE an email at
[email protected], and the DOE will respond with
instructions for submission of the LCA application.

Specific Instructions
To claim the credit for disposal of carbon oxide in secure
geological storage or for use of carbon oxide as a tertiary
injectant in an EOR or natural gas recovery project, prior
to disposal in secure geological sequestration, the amount
of carbon oxide must be measured at the source of
capture and verified either at the point of disposal in
secure geological storage or at the point of injection as a
tertiary injectant in an EOR or natural gas recovery
project. The amount of qualified carbon oxide is presumed
to be the lesser of the amount measured at capture and
the amount verified at disposal or injection unless it can
be established to the satisfaction of the IRS that the
greater amount is the correct amount.

Measurement. The measurement and written LCA report
must be performed by or verified by an independent third
party. The LCA report must be prepared in conformance
with, and contain documentation that conforms to, the
International Organization for Standardization (ISO)
14040:2006, Environmental Management—Life Cycle
Assessment—Principles and Framework and ISO
14044:2006, Environmental Management—Life Cycle
Assessment—Requirements and Guidelines, as well as a
statement documenting the qualifications of the
independent third party, including proof of appropriate
U.S. or foreign professional license, and an affidavit from
the third party stating that it's independent from you.

To claim the credit for utilization of carbon oxide, the
amount of qualified carbon oxide utilized by you is equal
to the metric tons of qualified carbon oxide that you
demonstrate, based upon an analysis of lifecycle
greenhouse gas emissions (LCA), were (1) captured and
permanently isolated from the atmosphere, or (2)
displaced from being emitted into the atmosphere. The
amount of qualified carbon oxide utilized by you for
purposes of the carbon oxide sequestration credit can't
exceed the amount of qualified carbon oxide measured at
the source of capture.

Approval of the LCA. You must submit the written LCA
report and independent third-party statement to the IRS
and the Department of Energy (DOE). The LCA will be
subject to a technical review by the DOE, and the IRS will
determine whether to approve the LCA.
You should fax a copy of your LCA report, including the
independent third-party statement specified in
Regulations section 1.45Q-4(c)(4), to the IRS at
844-255-4817. The submission should include a cover
letter with:
1. Name of the facility where the qualified carbon
oxide is utilized (“utilization facility”);
2. Name of the operator of the utilization facility,
including operator’s TIN/EIN;
3. Name of the taxpayer(s) claiming the credit based
on the LCA, including each taxpayer's TIN/EIN;
4. Name of a corporate officer in charge of the LCA
report submission (or a designated representative) with a
written power of attorney (POA on Form 2848) and that
person's contact information, including official corporate
mailing address;
5. Tax year in which the credit is claimed; and
6. Reserved for future use.

Part I. Information About You

Check the applicable box(es).

Box 1. Check box 1 if you captured qualified carbon
oxide during the tax year.
Box 2. Check box 2 if you physically disposed, used, or
utilized captured qualified carbon oxide during the tax
year.
Box 3. Check box 3 if you elected to allow another
person to claim the carbon oxide sequestration credit that
you would’ve otherwise been entitled to claim. See
Section 45Q(f)(3)(B) Election, earlier
Box 4. Check box 4 if another person elected to allow
you to claim the carbon oxide sequestration credit that
they would’ve otherwise been entitled to claim. See
Section 45Q(f)(3)(B) Election, earlier

Part II. Facilities at Which Qualified
Carbon Oxide Qualifies for a Credit
Under Section 45Q(a)(1) or (2), or for
Which an Election Was Made Under
Section 45Q(b)(3)

You should also mail (1) the items above, and (2) the
model, if the LCA wasn’t verified by an independent
third-party review, on a USB thumb drive, to:
Internal Revenue Service
Office of Associate Chief Counsel (PSI)
1111 Constitution Ave. NW
Branch 6 (CC:PSI:6), Room 5114
Washington, DC 20224

Line 1a

Enter the number of metric tons of qualified carbon oxide
captured using carbon capture equipment originally

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placed in service at a qualified facility before February 9,
2018 (or, on or after February 9, 2018, for facilities for
which an election was made under section 45Q(b)(3); see
Line 10. Section 45Q(b)(3) Election, later), disposed of in
secure geological storage, and not used as a tertiary
injectant in a qualified enhanced oil or natural gas
recovery project, or utilized in a way described in section
45Q(f)(5).

Line 1b

Enter inflation-adjusted credit rate. See 2022 credit rates
and applicable dollar amounts, earlier.

Line 2a

Enter the number of metric tons of qualified carbon oxide
captured using carbon capture equipment originally
placed in service at a qualified facility before February 9,
2018 (or, on or after February 9, 2018, for facilities for
which an election was made under section 45Q(b)(3); see
Line 10. Section 45Q(b)(3) Election, later), disposed of in
secure geological storage, and used as a tertiary injectant
in a qualified enhanced oil or natural gas recovery project.

Line 2b

Enter inflation-adjusted credit rate. See 2022 credit rates
and applicable dollar amounts, earlier.

Line 3a

Enter the number of metric tons of qualified carbon oxide
captured using carbon capture equipment originally
placed in service at a qualified facility before February 9,
2018 (or, on or after February 9, 2018, for facilities for
which an election was made under section 45Q(b)(3); see
Line 10. Section 45Q(b)(3) Election, later), and utilized as
described in section 45Q(f)(5).

Line 3b

Enter inflation-adjusted credit rate. See 2022 credit rates
and applicable dollar amounts, earlier.

Part III. Qualified Facilities Under
Section 45Q(a)(3) or (4) for Which No
Election Was Made Under Section
45Q(b)(3)
Line 4a

Enter the number of metric tons of qualified carbon oxide
captured using carbon capture equipment originally
placed in service at a qualified facility on or after February
9, 2018, during the 12-year period beginning on the date
the equipment was originally placed in service, disposed
of in secure geological storage, and not used as a tertiary
injectant in a qualified enhanced oil or natural gas
recovery project, nor utilized as described in section
45Q(f)(5).

Line 4b

Line 5a

Enter the number of metric tons of qualified carbon oxide
captured using carbon capture equipment originally
placed in service at a qualified facility on or after February
9, 2018, during the 12-year period beginning on the date
the equipment was originally placed in service, disposed
of in secure geological storage, and used as a tertiary
injectant in a qualified enhanced oil or natural gas
recovery project.

Line 5b

Enter section 45Q(a)(4) applicable dollar amount. See
2022 credit rates and applicable dollar amounts, earlier.

Line 6a

Enter the number of metric tons of qualified carbon oxide
captured using carbon capture equipment originally
placed in service at a qualified facility on or after February
9, 2018, during the 12-year period beginning on the date
the equipment was originally placed in service, and
utilized as described in section 45Q(f)(5).

Line 6b

Enter section 45Q(a)(4) applicable dollar amount. See
2022 credit rates and applicable dollar amounts, earlier.

Part IV. Qualified Direct Air Capture
Facilities Under Section 45Q(d)(2)(A)
Placed in Service After 2022
Line 7a

Qualified carbon oxide captured using carbon capture
equipment originally placed in service at a qualified direct
air capture facility after 2022, during the 12-year period
beginning on the date the equipment was originally placed
in service, disposed of in secure geological storage, and
not used as a tertiary injectant in a qualified enhanced oil
or natural gas recovery project, nor utilized as described
in section 45Q(f)(5).

Line 7b

Enter $36 for the section 45Q(b)(1)(B)(i) applicable dollar
amount ($180 if section 45Q(h)(2) requirements are met).

Line 8a

Qualified carbon oxide captured using carbon capture
equipment originally placed in service at a qualified direct
air capture facility after 2022, during the 12-year period
beginning on the date the equipment was originally placed
in service, disposed of in secure geological storage, and
used as a tertiary injectant in a qualified enhanced oil or
natural gas recovery project.

Line 8b

Enter $26 for the section 45Q(b)(1)(B)(ii) applicable dollar
amount ($130 if section 45Q(h)(2) requirements are met).

Enter section 45Q(a)(3) applicable dollar amount. See
2022 credit rates and applicable dollar amounts, earlier.
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Line 9a

Qualified carbon oxide captured using carbon capture
equipment originally placed in service at a qualified direct
air capture facility after 2022, during the 12-year period
beginning on the date the equipment was originally placed
in service and utilized as described in section 45Q(f)(5).

Line 9b

Enter $26 for the section 45Q(b)(1)(B)(ii) applicable dollar
amount ($130 if section 45Q(h)(2) requirements are met).

Part V. Other Information
Line 10. Section 45Q(b)(3) Election

You may check the box to elect having the dollar amounts
applicable under section 45Q(a)(1) or (2) apply in lieu of
the dollar amounts applicable under section 45Q(a)(3) or
(4) for each metric ton of qualified carbon oxide that is
captured by you using carbon capture equipment that is
originally placed in service at a qualified facility on or after
February 9, 2018. See the instructions for lines 1a, 2a, or
3a, earlier.

Line 11. Section 45Q(f)(6) Election

You may check the box to elect for applicable facilities
under section 45Q(f)(6)(A). Section 45Q(f)(6)(A) provides
that for any tax year in which an applicable facility
captures not less than 500,000 metric tons of qualified
carbon oxide, the person described in section 45Q(f)(3)
(A)(ii) may elect to have such applicable facility, and any
carbon capture equipment placed in service at such
applicable facility, deemed as having been placed in
service on February 9, 2018. The term “applicable facility”
means a qualified facility (i) that was placed in service
before February 9, 2018, and (ii) for which no taxpayer
claimed a carbon oxide sequestration credit in regards to
such facility for any tax year ending before February 9,
2018.

Line 12. Section 45Q(f)(9) Election

You may check the box to elect to have the 12-year period
begin on the first day of the first tax year in which a credit
under section 45Q is claimed with respect to carbon
capture equipment that is originally placed in service at a
qualified facility on or after February 9, 2018, if you own
the carbon capture equipment and physically or
contractually ensure the capture and disposal, utilization,
or use as a tertiary injectant of such qualified carbon
oxide; and if (i) no one claimed a credit under this section
with respect to such carbon capture equipment for any
prior tax year, (ii) the qualified facility at which such
carbon capture equipment is placed in service is located
in an area affected by a federally declared disaster (as
defined by section 165(i)(5)(A)) after the carbon capture
equipment is originally placed in service, and (iii) such
federally declared disaster results in a cessation of the
operation of the qualified facility or the carbon capture
equipment after such equipment is originally placed in
service.

Instructions for Form 8933 (Rev. 12-2022)

Line 13. Section 45Q(f)(3)(B) Election

If you checked box 4 in Part I, complete line 13 with
information reported to you on a statement substantially
similar to Model Certificate(s) ELECT by the electing
person(s). See Section 45Q(f)(3)(B) Election, earlier.

Lines 13a, 13b, and 13c. Complete lines 13a, 13b, and
13c with basic information reported to you on a statement
substantially similar to Model Certificate(s) ELECT by the
electing person(s), for the three largest elections (in
dollars).
(i) EIN of electing taxpayer.
(ii) Metric tons elected.
(iii) Credit rates.
(iv) Credit elected.
Line 13e. Report all other carbon oxide sequestration
credit that another person elected under section 45Q(f)(3)
(B) to allow you to claim. Subtract line 13d from the total
carbon oxide sequestration credit reported to you on a
statement substantially similar to Model Certificate(s)
ELECT, Part II, line 6; enter amount on line 13e.
Complete a statement substantially similar to
TIP Model Certificate ELECT if you elect under
section 45Q(f)(3)(B) to allow another person to
claim carbon oxide sequestration credit. See Model
Certificate ELECT, later.

Line 14

Enter the total qualified carbon oxide sequestration credits
from:
• Schedule K-1 (Form 1065), Partner's Share of Income,
Deductions, Credits, etc., box 15 (code P); and
• Schedule K-1 (Form 1120-S), Shareholder's Share of
Income, Deductions, Credits, etc., box 13 (code P).
Partnerships and S corporations report the above
credits on line 10 and their Schedule K. All others not
using earlier lines to figure a separate credit can report the
above credits directly on Form 3800, Part III, line 1x.

Line 16

Enter the carbon oxide sequestration credit recaptured.
Attach a statement substantially similar to Model
Certificate(s) RECAPTURE to Form 8933. Report the
credit recapture amount on the appropriate line of your
return.

Model Certificates

Per the TD and the NPRM that preceded it, if you’re a
large section 45Q project filer, you’ll likely have to use
multiple legal contracts with multiple parties for the
capture, utilization, or disposal of carbon oxides and,
generally to claim the credit, the existence of each
contract and the parties involved must be reported on
Form 8933 annually. For this reporting, filers should use
attachments substantially similar to model certificates
shown below.

Model Certificate CF. Use Model Certificate CF if you’re
the owner of a capture facility (may not be the same entity
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as the owner of the industrial facility) that emits carbon
oxide. Model Certificate CF will help show your share of
the carbon oxide sequestration credit.
Model Certificate DISP-Operator. Use Model
Certificate DISP-Operator if you’re the operator (or
designated operator) of a geologic disposal site at which
captured qualified carbon oxide was injected during the
calendar year. Don’t use this model certificate if carbon
oxide was injected for enhanced oil or natural gas
recovery. Provide a copy of your signed Model Certificate
DISP-Operator to each owner of the disposal site project.
Model Certificate DISP-Owner. Use Model Certificate
DISP-Owner if you’re the owner (or one of the owners) of
the geologic disposal site at which captured carbon oxide
was injected during the calendar year. The operator of the
disposal site prepares Table 3 of Model Certificate
DISP-Operator. Report the amounts from that Table 3 on
lines 11, 12, and 14 through 16.
Model Certificate EOR-Operator. Use Model Certificate
EOR-Operator if you’re the operator (or designated
operator) of an enhanced oil or gas recovery project (EOR
project) at which captured qualified carbon oxide was
injected during the calendar year. Provide a copy of your
signed Model Certificate EOR-Operator to each owner of
the EOR project.
Model Certificate EOR-Owner. Use Model Certificate
EOR-Owner if you’re the owner (or one of the owners) of

the EOR project at which captured carbon oxide was
injected during the calendar year. The operator of the
EOR project prepares Table 3 of Model Certificate
EOR-Operator. Report the amounts from that Table 3 on
lines 11, 12, and 14 through 16.
Model Certificate UTZ. Use Model Certificate UTZ if
you’re the owner of the utilization facility who utilized
qualified carbon oxide during the calendar year. Don’t
combine information from separate utilization facilities on
the same Model Certificate UTZ. Provide a copy of your
signed Model Certificate UTZ to each supplier that
supplied qualified captured carbon oxide to inform the
suppliers of the amount of their qualified carbon oxide that
was utilized.
Model Certificate ELECT. Use Model Certificate ELECT
if (1) you’re the owner of the capture facility that supplied
qualified carbon oxide to another person that was properly
disposed of in geological storage, used in an EOR project,
or utilized in a manner consistent with section 45Q(f), and
(2) you elect under section 45Q(f)(3)(B) to allow the
carbon oxide sequestration credit to that person. You
must make a separate election for each qualified facility.
Model Certificate RECAPTURE. Use Model Certificate
RECAPTURE if you’re the operator or owner of the
geologic disposal site or EOR project to report a recapture
event.

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Model Certificate CF
Capture Facility Certification
Name(s) shown on return:

2022
Identifying number:

Part I. Information About Industrial Facility, Carbon Capture Equipment, Carbon Oxide Sequestration Credit, and Elections
Yes No
Section 1—Industrial facility information:
1
Name of facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2

Location (county and state)

3

Facility's EPA e-GGRT ID number(s)* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4

Is the facility an electricity-generating facility? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5

Is the facility a direct air capture facility? If “Yes,” skip to line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6
7

If the facility isn’t an electricity-generating or direct air capture facility, state the nature of
the facility (for example, ethanol production, cement manufacturing, etc.) . . . . . . . . .
What is the placed-in-service date of the facility (MM/DD/YYYY)? . . . . . . . . . . . . .

8

Does the facility described above process carbon dioxide or any other gas from underground deposits? . . . . . . . . . . . . . .

8a

9a

If you answered “Yes” to line 8, was any gas obtained from a carbon dioxide production well at natural carbon dioxide-bearing
formations or at a naturally occurring subsurface spring, which means a well that contains 90% or greater carbon dioxide by
volume? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If you answered “Yes” to line 8a, you can’t treat the facility as a qualified industrial facility to the extent that it processed gas
described in line 8a during the tax year. See line 8c.
If you answered “Yes” to line 8a, do you attest that you meet the exception for a deposit that contains a product, other than
carbon oxide, that is commercially viable to extract and sell without taking into account the availability of a commercial market for
the carbon oxide that is extracted or any carbon oxide sequestration credit that might be available? . . . . . . . . . . . . . . . . .
If you answered “Yes” to line 8c, have you attached an attestment letter from an independent registered engineer? Don’t treat the
facility as a qualified industrial facility unless you answered “Yes” to both lines 8c and 8d. See instructions . . . . . . . . . . . . .
What were the emissions of carbon oxide during the calendar year (amount released to
the atmosphere plus amount captured)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Of the amount listed on line 9, what amount was carbon dioxide? . . . . . . . . . . . . . .

9b

Of the amount listed on line 9, what amount was carbon monoxide? . . . . . . . . . . . .

10

Was annualization of first-year carbon oxide emissions required for this calendar year? . . . . . . . . . . . . . . . . . . . . . . . . .

10a

If you answered “Yes” to line 10, state the annualized carbon oxide emissions and attach
a statement that shows how you determined the annualized carbon oxide
emissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Was aggregation of multiple facilities required to achieve the requisite carbon capture thresholds?

8b
8c
8d
9

11

. . . . . . . . . . . . . . . . .

11a If you answered “Yes” to line 11, attach a statement that lists the facilities and describes the appropriateness of their aggregation.
Section 2—Carbon capture equipment and direct air capture facility information:
12 Is carbon capture done by a direct air capture facility? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
14
15

State the location of the carbon capture equipment or direct air capture facility (county
and state) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Was any carbon capture equipment placed in service prior to February 9, 2018? See instructions

. . . . . . . . . . . . . . . . . .

16

What was the placed-in-service date (MM/DD/YYYY) of the carbon capture equipment or
direct air capture facility described on line 13? See instructions . . . . . . . . . . . . . . .
Are you the owner of the carbon capture equipment described on line 13? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16a

If you answered “No” to line 16, state your basis for claiming the credit

17

For carbon capture equipment placed in service after February 9, 2018, do you attest that, to the best of your knowledge, you are
the only person who will claim carbon oxide sequestration credit with respect to carbon oxide captured by each single train of
carbon capture equipment during the tax year (irrespective of any election you make to allow a contracting disposer, injector, or
utilizer to claim credit)? Don’t claim the credit unless you can answer “Yes.” See instructions . . . . . . . . . . . . . . . . . . . . . .
For the carbon capture equipment described on line 13, what was the carbon capture
capacity on or after February 8, 2018? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18

. . . . . . . . . .

* if available
Model Certificate CF

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Page 2

Part I. Information About Industrial Facility, Carbon Capture Equipment, Carbon Oxide Sequestration Credit, and Elections
(continued)
19 Was additional carbon capture equipment installed on or after February 9, 2018?

Yes No

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19a For equipment described on line 19, what was the beginning of construction date
(MM/DD/YYYY)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19b For equipment described on line 19, what was the placed-in-service date (MM/DD/
YYYY)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19c Is the placed-in-service date of the carbon capture equipment described on line 19 determined pursuant to the 80/20 rule?

. . . .

19d If you answered “Yes” to line 19c, state your investment in new carbon capture
equipment and the fair market value of pre-existing carbon capture equipment . . .
19e If the placed-in-service date of the carbon capture equipment was determined pursuant to the 80/20 rule, did you include its
investment in a transportation pipeline as new carbon capture equipment? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19f If you answered “Yes” to line 19e, state your investment in a transportation
pipeline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20 What was the total amount of carbon oxide captured during the calendar year (in
metric tons)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20a Of the amount listed on line 20, what amount was carbon dioxide? . . . . . . . . . . .
20b Of the amount listed on line 20, what amount was carbon monoxide? . . . . . . . . .
21 Was annualization of first-year captured carbon oxide required for this calendar year?

. . . . . . . . . . . . . . . . . . . . . . . . . . .

21a If you answered “Yes” to line 21, state the annualized carbon oxide emissions . . . .
Section 3—Information about carbon oxide sequestration credit and your elections:
22 During the calendar year, are other parties contractually ensuring disposal, injection, or utilization of qualified carbon oxide
captured at this facility? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23 For this calendar year, do you elect to allow any of the parties described on line 22 to claim some or all of the carbon oxide
sequestration credit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24 If you answered “No” to line 14, do you elect to apply the $10 and $20 rates (adjusted for inflation) in lieu of the applicable dollar
amounts? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
25 If you answered “Yes” to line 24, determine the credit using lines 1, 2, or 3 in Part II.
26 If you answered “No” to line 24, determine the credit using lines 4, 5, or 6 in Part III.
27 Is the facility described in Part I an applicable facility and are you making the election under section 45Q(f)(6)? See
instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27a If you answered “Yes” to both parts of line 27, determine the credit using lines 4, 5, or 6 in Part III. See instructions.

.
.
.

.

Part II. Facilities at Which Qualified Carbon Oxide Qualifies for a Credit Under Section 45Q(a)(1) or (2), or for Which an Election Was
Made Under Section 45Q(b)(3)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility before February 9, 2018 (or, on or
after February 9, 2018, for facilities for which an election was made under section 45Q(b)(3)), disposed of in secure geological storage, and not
used as a tertiary injectant in a qualified enhanced oil or natural gas recovery project, nor utilized as described in section 45Q(f)(5).

(a) Metric tons

(b) Rate

1a

Metric tons captured and delivered to point of disposal

1b

Metric tons captured and securely stored by you. Attach Model Certificates
DISP-Operator and DISP-Owner for each disposal site . . . . . . . . . . . . . . . . . .

1c

Metric tons captured and securely stored (physically disposed) by another person.
Attach Model Certificates DISP-Operator and DISP-Owner for each disposal site . .

1d

Add lines 1b and 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$25.07

1e

Metric tons captured and securely stored (physically disposed) by another person and
for which you allow that person to claim the resulting carbon oxide sequestration credit.
Attach Model Certificate ELECT for each disposal site . . . . . . . . . . . . . . . . . .

$25.07

1f

Your carbon oxide sequestration credit. Subtract line 1e from line 1d . . . . . . . . . .

$25.07

(c) Carbon oxide
sequestration
credit. Multiply
column (a) by
column (b).

. . . . . . . . . . . . . . . . . .

Model Certificate CF

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Page 3

Part II. Facilities at Which Qualified Carbon Oxide Qualifies for a Credit Under Section 45Q(a)(1) or (2), or for Which an Election Was
Made Under Section 45Q(b)(3) (continued)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility before February 9, 2018, disposed
of in secure geological storage, and used as a tertiary injectant in a qualified enhanced oil or natural gas recovery project.
(a) Metric tons
2a Metric tons captured and delivered to point of injection

(b) Rate

(c) Carbon oxide
sequestration credit.
Multiply column (a)
by column (b).

. . . . . . . . . . . . . . . . . .

2b Metric tons captured and securely stored by you. Attach Model Certificates
EOR-Operator and EOR-Owner for each recovery project . . . . . . . . . . . . . . . .
2c Metric tons captured and securely stored by another person. Attach Model Certificates
EOR-Operator and EOR-Owner for each recovery project . . . . . . . . . . . . . . . .
2d Add lines 2b and 2c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$12.53

2e Metric tons captured and securely stored by another person and for which you allow
that person to claim the resulting carbon oxide sequestration credit. Attach Model
Certificate ELECT for each recovery project . . . . . . . . . . . . . . . . . . . . . . . . .

$12.53

2f Your carbon oxide sequestration credit. Subtract line 2e from line 2d . . . . . . . . . .

$12.53

Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility before February 9, 2018, and
utilized as described in section 45Q(f)(5).
(a) Metric tons

(b) Rate

(c) Carbon oxide
sequestration credit.
Multiply column (a)
by column (b).

3a Metric tons captured and delivered to point of utilization . . . . . . . . . . . . . . . . . .
3b Metric tons captured and physically utilized by you. Attach Model Certificate UTZ for
each utilization facility. Expressed as carbon dioxide equivalents that were determined
pursuant to an approved Life Cycle Assessment (LCA). See instructions . . . . . . .
3c Metric tons captured and physically utilized by another person. Attach Model
Certificate UTZ for each utilization facility. Expressed as carbon dioxide equivalents
that were determined pursuant to an approved LCA. See instructions . . . . . . . . .
3d Add lines 3b and 3c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$12.53

3e Metric tons captured and physically utilized by another person and for which you elect
to allow that person to claim the resulting carbon oxide sequestration credit.
Expressed as carbon dioxide equivalents that were determined pursuant to an
approved LCA. See instructions. Attach Model Certificate ELECT for each utilization
facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$12.53

3f Your carbon oxide sequestration credit. Subtract line 3e from line 3d . . . . . . . . . .

$12.53
Model Certificate CF

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Page 4

Part III. Qualified Facilities Under Section 45Q(a)(3) or (4) for Which No Election Was Made Under Section 45Q(b)(3)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9, 2018,
during the 12-year period beginning on the date the equipment was originally placed in service, disposed of in secure geological storage, and not
used as a tertiary injectant in a qualified enhanced oil or natural gas recovery project, nor utilized as described in section 45Q(f)(5).
(a) Metric tons
4a Metric tons captured and delivered to point of disposal

(b) Rate

(c) Carbon oxide
sequestration credit.
Multiply column (a)
by column (b).

. . . . . . . . . . . . . . . . . .

4b Metric tons captured and securely stored (physically disposed) by you. Attach Model
Certificates DISP-Operator and DISP-Owner for each disposal site . . . . . . . . . . .
4c Metric tons captured and securely stored (physically disposed) by another person.
Attach Model Certificates DISP-Operator and DISP-Owner for each disposal site . .
4d Add lines 4b and 4c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$37.85

4e Metric tons captured and securely stored (physically disposed) by another person and
for which you allow that person to claim the resulting carbon oxide sequestration.
Attach Model Certificate ELECT for each disposal site . . . . . . . . . . . . . . . . . . .

$37.85

4f

$37.85

Your carbon oxide sequestration credit. Subtract line 4e from line 4d . . . . . . . . . .

Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9, 2018,
during the 12-year period beginning on the date the equipment was originally placed in service, disposed of in secure geological storage, and used
as a tertiary injectant in a qualified enhanced oil or natural gas recovery project.
(a) Metric tons
5a Metric tons captured and delivered to point of injection

(b) Rate

(c) Carbon oxide
sequestration credit.
Multiply column (a)
by column (b).

. . . . . . . . . . . . . . . . . .

5b Metric tons captured and securely stored (physically disposed) by you. Attach Model
Certificates EOR-Operator and EOR-Owner for each recovery project . . . . . . . . .
5c Metric tons captured and securely stored (physically disposed) by another person.
Attach Model Certificates EOR-Operator and EOR-Owner for each recovery
project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5d Add lines 5b and 5c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$25.15

5e Metric tons captured and securely stored (physically disposed) by another person and
for which you allow that person to claim the resulting carbon oxide sequestration.
Attach Model Certificate ELECT for each recovery project . . . . . . . . . . . . . . . .

$25.15

5f

$25.15

Your carbon oxide sequestration credit. Subtract line 5e from line 5d . . . . . . . . . .

Model Certificate CF

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Page 5

Part III. Qualified Facilities Under Section 45Q(a)(3) or (4) for Which No Election Was Made Under Section 45Q(b)(3) (continued)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9, 2018,
during the 12-year period beginning on the date the equipment was originally placed in service, and utilized as described in section 45Q(f)(5).
(a) Metric tons

(b) Rate

(c) Carbon oxide
sequestration credit.
Multiply column (a)
by column (b).

6a Metric tons captured and delivered to point of utilization . . . . . . . . . . . . . . . . . .
6b Metric tons captured and physically utilized by you. Attach Model Certificate UTZ for
each utilization facility. Expressed as carbon dioxide equivalents . . . . . . . . . . . .
6c Metric tons captured and physically utilized by another person. Attach Model
Certificate UTZ for each utilization facility. Expressed as carbon dioxide
equivalents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6d Add lines 6b and 6c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$25.15

6e Metric tons captured and physically utilized by another person and for which you elect
to allow that person to claim the resulting carbon oxide sequestration credit.
Expressed as carbon dioxide equivalents. Attach Model Certificate ELECT for each
utilization project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$25.15

6f Your carbon oxide sequestration credit. Subtract line 6e from line 6d . . . . . . . . . .

$25.15

Part IV. Qualified Direct Air Capture Facilities Under Section 45Q(d) Placed in Service After 2022
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified direct air capture facility after 2022 during
the 12-year period beginning on the date the equipment was originally placed in service, disposed of in secure geological storage, and not used as
a tertiary injectant in a qualified enhanced oil or natural gas recovery project, nor utilized as described in section 45Q(f)(5).
(a) Metric tons
7a Metric tons captured and delivered to point of disposal

(b) Rate

(c) Carbon oxide
sequestration credit.
Multiply column (a)
by column (b).

. . . . . . . . . . . . . . . . . .

7b Metric tons captured and securely stored (physically disposed) by you. Attach Model
Certificates DISP-Operator and DISP-Owner for each disposal site . . . . . . . . . . .
7c Metric tons captured and securely stored (physically disposed) by another person.
Attach Model Certificates DISP-Operator and DISP-Owner for each disposal site . .
7d Sum of 7b and 7c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$36

7e Metric tons captured and securely stored (physically disposed) by another person and
for which you allow that person to claim the resulting carbon oxide sequestration.
Attach Model Certificate ELECT for each disposal site . . . . . . . . . . . . . . . . . . .

$36

7f Your carbon oxide sequestration credit. Subtract line 7e from line 7d . . . . . . . . . .

$36

Note. Enter $180 in column (b) for lines 7d, 7e, and 7f if section 45Q(h)(2) requirements are met.
Model Certificate CF

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Page 6

Part IV. Qualified Direct Air Capture Facilities Under Section 45Q(d) Placed in Service After 2022 (continued)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified direct air capture facility after 2022 during
the 12-year period beginning on the date the equipment was originally placed in service, disposed of in secure geological storage, and used as a
tertiary injectant in a qualified enhanced oil or natural gas recovery project.
(a) Metric tons
8a Metric tons captured and delivered to point of injection

(b) Rate

(c) Carbon oxide
sequestration credit.
Multiply column (a)
by column (b).

. . . . . . . . . . . . . . . . . .

8b Metric tons captured and securely stored (physically disposed) by you. Attach Model
Certificates EOR-Operator and EOR-Owner for each recovery project . . . . . . . . .
8c Metric tons captured and securely stored (physically disposed) by another person.
Attach Model Certificates EOR-Operator and EOR-Owner for each recovery
project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8d Add lines 8b and 8c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$26

8e Metric tons captured and securely stored (physically disposed) by another person and
for which you allow that person to claim the resulting carbon oxide sequestration.
Attach Model Certificate ELECT for each recovery project . . . . . . . . . . . . . . . .

$26

8f Your carbon oxide sequestration credit. Subtract line 8e from line 8d . . . . . . . . . .

$26

Note. Enter $130 in column (b) for lines 8d, 8e, and 8f if section 45Q(h)(2) requirements are met.
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified direct air capture facility after 2022 during
the 12-year period beginning on the date the equipment was originally placed in service, and utilized as described in section 45Q(f)(5).
(a) Metric tons

(b) Rate

(c) Carbon oxide
sequestration credit.
Multiply column (a)
by column (b).

9a Metric tons captured and delivered to point of utilization . . . . . . . . . . . . . . . . . .
9b Metric tons captured and physically utilized by you. Attach Model Certificate UTZ for
each utilization facility. Expressed as carbon dioxide equivalents . . . . . . . . . . . .
9c Metric tons captured and physically utilized by another person. Attach Model
Certificate UTZ for each utilization facility. Expressed as carbon dioxide
equivalents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9d Sum of 9b and 9c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$26

9e Metric tons captured and physically utilized by another person and for which you elect
to allow that person to claim the resulting carbon oxide sequestration credit.
Expressed as carbon dioxide equivalents. Attach Model Certificate ELECT for each
utilization project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$26

9f Your carbon oxide sequestration credit. Subtract line 9e from line 9d . . . . . . . . . .

$26

Note. Enter $130 in column (b) for lines 9d, 9e, and 9f if section 45Q(h)(2) requirements are met.
Model Certificate CF

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Page 7

Capture Facility Certification (continued)
Under penalties of perjury, I attest that I am an officer of the company that is the owner of the subject capture facility. I further attest that the above
information is true and correct.

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN
Model Certificate CF

Instructions for Form 8933 (Rev. 12-2022)

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Model Certificate DISP-Operator
Disposal Operator Certification

2022

Name(s) shown on return:

Identifying number:

Information about the owners of the geologic disposal site:
1 In Table 1 below, list information about each owner of the disposal site during the calendar year. If there are more than four owners, prepare a
separate table with all the owner information and attach it to this model certificate.
If one or more of the owners is a partnership or S corporation, provide information for the pass-through entity, not partners or shareholders.
If one or more of the owners is part of a joint venture that has elected out of subchapter K of the Code, provide information for all such owners.
Table 1 — Information About the Owner(s) of the Disposal Site
Disposal site owner

Name

Address

EIN

Operating
interest
(%)

1
2
3
4
Information about the geologic disposal site:
2 Name and location (county and state, or offshore tract) . . . . . . . . . . . . . . . . . . . . . . . . . . .
3

List the name and EIN of the operator of the site

4
5

List any other companies that are identified as the operator of the project for any other purpose(s)
and the nature of the purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Geologic disposal site’s EPA e-GGRT ID number(s)* . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6

When did injection of captured qualified carbon oxide begin (MM/YYYY)? . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7

Check here to declare that all figures of stored carbon oxide on this certificate are for carbon oxide consistent with figures reported to
the EPA pursuant to the applicable MRV plan and subpart RR of the EPA's Greenhouse Gas Reporting Program . . . . . . . . . . . . .
8 Attach a copy of the approved MRV plan or provide the URL where it can be viewed on the EPA website.
Information about the qualified carbon oxide supplied to the geologic disposal site and securely stored:
9 In Table 2, provide information about all suppliers of qualified carbon oxide during the calendar year. “Qualified” carbon oxide means carbon
oxide from a supplier who attests that the carbon oxide was captured at one of its qualified section 45Q facilities. For qualified carbon oxide,
“supplier” means the person who captured the qualified carbon oxide, which may differ from the company that sold the qualified carbon oxide
or physically delivered the qualified carbon oxide to the owner of the geologic disposal site.
Table 2 — Information About Suppliers of Qualified Carbon Oxide
Qualified carbon
oxide supplier

Name

EIN

Name and location of
capture facility
(county, state)

Check if supplier
supplied any
EPA's e-GGRT ID*
nonqualified
carbon oxide from
any source

1
2
3
* if available
Model Certificate DISP‐Operator

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Page 2

Disposal Operator Certification (continued)
10 Complete Table 3 below using information that is consistent with all applicable EPA filings. If there are more than four owners of the geologic
disposal site or suppliers of qualified carbon oxide, prepare a separate table with all the supplier information and attach it to this model
certificate.
11 Check here to attest that all figures in Table 3 conform to all applicable EPA filings . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Table 3 — Information About Disposal
Qualified carbon
oxide supplier
number 1

Qualified carbon
oxide supplier
number 2

(C)
(A)
(B)
(D)
(E)
Metric
Geologic
Metric
Metric
Metric
tons
disposal
tons
tons
tons
store
site owner delivered
delivered stored
d

Qualified carbon
oxide supplier
number 3

Total qualified
carbon oxide from
all suppliers

All other suppliers
of nonqualified
carbon oxide

(H)
(I) Metric
Metric
tons
(F)
(G)
tons
(J)
stored
Metric
Metric delivered
Metric
(add
tons
tons
(add
tons
columns
delivered stored columns
delivered
(C), (E),
(B), (D),
and (G))
and (F))

(K)
Metric
tons
stored

Total metric tons for all
carbon oxide suppliers

(L) Metric
(M) Metric
tons
tons stored
delivered
(add
(add
columns (I)
columns
and (K))
(H) and (J))

1
2
3
4
5

Total
(add lines
1 through
4)

Under penalties of perjury, I attest that I am an officer of the company that is the operator of the subject geologic disposal site or that I have been
designated by the operating interest owners to prepare and submit this certificate to the IRS on their behalf. I further attest that the above information
is true and correct.

Signature and date signed

Printed or typed name of person signing this report

Title

Company’s name and EIN

Model Certificate DISP‐Operator

Instructions for Form 8933 (Rev. 12-2022)

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Model Certificate DISP‐Owner
Disposal Owner Certification

2022

Name(s) shown on return:

Identifying number:

Information about you, the owner of the geologic disposal site:
1 Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Address
3 EIN

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Information about your suppliers of qualified carbon oxide. Complete a separate Model Certificate DISP-Owner for each of your
suppliers of qualified carbon oxide:
4 Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 EIN

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6 Name and location of qualified carbon oxide capture facility (if supplier supplied any qualified
carbon oxide) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7 Type of industrial facility at which the supplier captured its qualified carbon oxide . . . . . . . . . . .
8 Check here if you were one of the suppliers. Don’t check unless the EIN of the supplier of the qualified carbon oxide is the same
as the EIN of the entity that is an owner of the geologic disposal site. If the EINs aren’t the same, there must be a binding written
contract between the entities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9 Unless line 8 is checked, do you attest that a binding written contract between you and the supplier exists that ensures that you
will securely store the qualified carbon oxide in the manner required under section 45Q and the underlying regulations? . . .

Yes

No

10 Provide the date (MM/DD/YYYY) of the contract referenced in the line above or the date of the most
recent amendment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11 Metric tons of qualified carbon oxide received from the supplier during the calendar year (metric
tons should agree with the figure reported for you for this supplier by the project's operator in Model
Certificate DISP‐Operator, Table 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12 Metric tons of qualified carbon oxide received from the supplier and stored by you during the
calendar year (metric tons should agree with the figure reported for you for this supplier by the
disposal site's operator in Model Certificate DISP‐Operator, Table 3) . . . . . . . . . . . . . . . . . .
13 Metric tons of nonqualified carbon oxide received by you during the calendar year . . . . . . . . . .
14 Metric tons of nonqualified carbon oxide stored by you during the calendar year (metric tons should
be from Model Certificate DISP‐Operator, Table 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15 Add lines 11 and 13. Total amount of qualified carbon oxide injected (amount should agree with the
figure reported for you in Model Certificate DISP-Operator, Table 3) . . . . . . . . . . . . . . . . . . .
16 Add lines 12 and 14. Total amount of qualified carbon oxide stored (amount should agree with the
figure for you in Model Certificate DISP-Operator, Table 3) . . . . . . . . . . . . . . . . . . . . . . . . .
17 Reserved for future use.
18 Check here if you attest that the supplier of qualified carbon oxide elected to allow you to claim some or all of the carbon oxide
sequestration credit attributable to their qualified carbon oxide. If you checked the box, attach a copy of Model Certificate
ELECT signed by the supplier for this calendar year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Under penalties of perjury, I attest that I am an officer of the company that is the owner of the subject DISP project. I further attest that the above
information is true and correct and that I have provided a signed copy of this completed certificate to each person who supplied qualified carbon
oxide to my company for use at the subject DISP project during this calendar year.

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN
Model Certificate DISP‐Owner

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Model Certificate EOR‐Operator
Enhanced Oil Recovery Operator Certification
Name(s) shown on return:

2022
Identifying number:

Information about the owners of the EOR project:
1 In Table 1 below, list information about each owner of the EOR project during the calendar year. If there are more than four owners, prepare a
separate table with all the owner information and attach it to this model certificate.
If one or more of the owners is a partnership or S corporation, provide information for the pass-through entity, not partners or shareholders.
If one or more of the owners is part of a joint venture that has elected out of subchapter K of the Code, provide the information for all such
owners.
Table 1 — Information About the Owner(s) of the EOR Project
EOR project
owner

Name

Address

EIN

Operating
interest (%)

1
2
3
4
Information about the EOR project:
2 Name and location (county and state) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3

5

List the name and EIN of the person who, for purposes of Regulations section 1.45Q-2(h), is
the operator of the project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
List any other companies that are identified as the operator of the project for any other
purpose(s) and the nature of the purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
EPA e-GGRT ID number(s)* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6

Date (MM/YYYY) on which the injection of captured qualified carbon oxide began . . . . . . .

7

If the project was previously certified under section 43, state the name of the certified project
and date (MM/DD/YYYY) of the petroleum engineer's certification . . . . . . . . . . . . . . . . .
If the project wasn’t previously certified under section 43, attach a copy of a valid petroleum engineer's certification to this Model Certificate
EOR-Operator.
Yes No
Is this project an enhanced natural gas recovery project? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4

8

9

10 Are all injection wells appropriately permitted? See Secure geological storage, earlier . . . . . . . . . . . . . . . . . . . . . . . . . .
11 If you answered “No” to line 10, the carbon oxide sequestration credit can’t be claimed.
12 Are any of the wells in the project EPA Class VI? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13 If you answered “Yes” to line 12, check here to declare that all figures of stored qualified carbon oxide on this model
certificate are consistent with figures reported to the EPA pursuant to the applicable MRV plan and subpart RR of
EPA’s Greenhouse Gas Reporting Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14 If you answered “Yes” to line 12, provide the EPA approval date (MM/DD/YYYY) of the MRV
plan, and attach a copy of the approved MRV plan or its URL on the EPA's website . . . . . .
15 If you answered “Yes” to line 10 and “No” to line 12, are you relying on subpart RR of the
Greenhouse Gas Reporting Program or ISO 27916 to demonstrate secure storage (check
which one)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Subpart RR
ISO 27916
16 If line 15 is subpart RR, provide the EPA approval date (MM/DD/YYYY) of the MRV plan, and
attach a copy of the approved MRV plan or its URL on the EPA's website . . . . . . . . . . . . .
17 If line 15 is ISO 27916, attach a copy of the ISO 27916 documentation for the year.
18 If line 15 is ISO 27916, attach a copy of the certification completed by a qualified independent engineer or geologist.
Information about the qualified carbon oxide supplied to the EOR project and securely stored:
19 In Table 2, provide information about all suppliers of qualified carbon oxide during the calendar year. “Qualified” carbon oxide means carbon
oxide from a supplier who attests that the carbon oxide was captured at one of its qualified 45Q facilities. For qualified carbon oxide, “supplier”
means the person who captured the qualified carbon oxide, who may differ from the company that sold the carbon oxide or physically
delivered the carbon oxide to the owner of the EOR utilization facility.
* if available
Model Certificate EOR‐Operator

Instructions for Form 8933 (Rev. 12-2022)

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Page 2

Enhanced Oil Recovery Operator Certification (continued)
Table 2 — Information About Suppliers of Qualified Carbon Oxide

Qualified
carbon oxide
supplier

Name

EIN

Name of
capture facility

Check if
supplier
Location of capture
Check if supplier
provided
facility
provided any qualified
any
(county, state)
carbon oxide
nonqualified
carbon
oxide

1
2
3
20

21

Complete Table 3 below using information that conforms to all applicable EPA filings and certified ISO 27916 documentation if it was used to
demonstrate secure storage. If there are more than four owners of the EOR project or three suppliers of qualified carbon oxide, prepare a
separate table that includes all relevant information and attach it to this model certificate.
Check here to attest that all figures in Table 3 conform to all applicable EPA filings and certified ISO 27916 documentation .
Table 3 — Information About Enhanced Oil Recovery
Qualified carbon
oxide supplier
number 1

(A) EOR
project
owner

Qualified carbon
oxide supplier
number 2

Qualified carbon
oxide supplier
number 3

Total qualified
carbon oxide from
all suppliers

(H)
Metric
(B)
(C)
(D)
(E)
(F)
(G)
tons
Metric
Metric
Metric Metric Metric
Metric delivered
tons
tons
tons
tons
tons
tons
(add
delivered stored delivered stored delivered stored columns
(B), (D),
and (F))

All other
suppliers of
nonqualified
carbon oxide

Total metric tons for all
carbon oxide suppliers

(I)
Metric
tons
(L) Metric
(J)
(K)
tons
stored
Metric
Metric
delivered
(add
tons
tons
(add columns
columns
delivered stored
(C),
(H) and (J))
(E), and
(G))

(M) Metric
tons stored
(add
columns (I)
and (K))

1
2
3
4
5 Total (add
lines 1
through 4)
Under penalties of perjury, I attest that I am an officer of the company that is the operator of the subject EOR project or that I have been designated
by the operating interest owners to prepare and submit this certificate to the IRS on their behalf. I further attest that the above information is true and
correct.

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN
Model Certificate EOR‐Operator

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Model Certificate EOR‐Owner
Enhanced Oil Recovery Owner Certification
Name(s) shown on return:

2022
Identifying number:

Information about you, the owner of the EOR project:
1 Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2

Address

3

EIN

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Information about all suppliers of qualified carbon oxide to you. Complete multiple model certificates if you had more than one
supplier of qualified carbon oxide:
4 Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5

EIN

6

Name and location (county, state) of qualified carbon oxide capture facility . . . . . . . . . . .

7

Type of industrial facility at which the supplier captured its qualified carbon oxide . . . . . . .

8

Check here if you were one of the suppliers. Don’t check unless the EIN of the supplier of the qualified carbon oxide is the
same as the EIN of the entity that is an owner of the geologic disposal site. If the EINs aren’t the same, there must be a
binding written contract between the entities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Unless line 8 is checked, do you attest that a binding written contract between you and the supplier exists that ensures that
you will securely store the qualified carbon oxide in the manner required under section 45Q and the underlying regulations?

9
10
11
12
13
14
15
16
17
18

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

No

Provide the date (MM/DD/YYYY) of the contract referenced in the line above or the date of the
most recent amendment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Metric tons of qualified carbon oxide received from the supplier during the calendar year
(metric tons should agree with the figure reported for you for this supplier by the project's
operator in Model Certificate EOR‐Operator, Table 3) . . . . . . . . . . . . . . . . . . . . . . . .
Metric tons of qualified carbon oxide stored by you during the year (metric tons should agree
with the figure reported for you for this supplier by the disposal site's operator in Model
Certificate EOR‐Operator, Table 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Metric tons of nonqualified carbon oxide received by you during the year . . . . . . . . . . . .
Metric tons of nonqualified carbon oxide utilized as a tertiary injectant stored by you during the
calendar year (metric tons should be from Model Certificate EOR-Operator, Table 3) . . . .
Add lines 11 and 13. Total amount of qualified carbon oxide injected (amount should agree
with the figure for you in Model Certificate EOR-Operator, Table 3) . . . . . . . . . . . . . . . .
Add lines 12 and 14. Total amount of qualified carbon oxide stored (amount should agree with
the figure for you in Model Certificate EOR-Operator, Table 3) . . . . . . . . . . . . . . . . . . .
Reserved for future use.
Check here if you attest that the supplier of qualified carbon oxide elected to allow you to claim some or all of the carbon oxide
sequestration credit attributable to their qualified carbon oxide. If you checked the box, attach a copy of Model Certificate
ELECT signed by both you and the supplier for this calendar year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under penalties of perjury, I attest that I am an officer of the company that is the owner of the subject EOR project. I further attest that the above
information is true and correct and that I have provided a signed copy of this completed certificate to each person who supplied qualified carbon
oxide to my company for use at the subject EOR project during this year.

Signature and date signed

Printed or typed name and title of person signing this report

Title

Company's name and EIN
Model Certificate EOR‐Owner

Instructions for Form 8933 (Rev. 12-2022)

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Model Certificate UTZ
Utilization Certification

2022

Name(s) shown on return:

Identifying number:

Part I. Information About the Qualified Carbon Utilization Facility and Utilization of Carbon Oxide
Section 1—Information about owner or lessee(s) of the qualified carbon utilization facility and utilization of qualified carbon oxide at
this facility:
1 In Table 1 below, list information about each owner or lessee of the qualified carbon oxide utilization facility during the calendar year. If there are
more than four owners or lessees, prepare a separate table with all the owner or lessee information and attach it to this model certificate.
Note. If one or more of the owners is a partnership or S corporation, provide information for the pass-through entity, not partners or
shareholders.
Table 1 — Information About the Owner(s) or Lessee(s) of the Qualified Carbon Utilization Facility
Owner/Lessee

Name

Address

EIN

Operating interest (%)

1
2
3
4
Total
2 Name of the utilization facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 Location of the utilization facility (street, county, and state) . . . . . . . . . . . . . .
4 Registered owner or operator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 Provide information about utilization of qualified carbon oxide at this facility below.
Check all that apply
a

Fixation through photosynthesis or
chemosynthesis, such as through the growing of
algae or bacteria.

b

Chemical conversion to a material or chemical
compound in which qualified carbon oxide is
securely stored.

c

For any other purpose for which a commercial
market exists (with the exception of use as a
tertiary injectant in a qualified enhanced oil or
natural gas recovery project), as determined by
regulations or other official guidance.

Describe in more detail how the qualified carbon oxide is utilized

5.1 Do you attest that a commercial market exists for your particular product, process, or service?

Yes No
. . . . . . . . . . . . . . . . . . . . . . .

5.2 Have you attached a statement substantiating that a commercial market exists? Don’t complete this model certificate unless you
answered “Yes” to the questions on lines 5.1 and 5.2. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Model Certificate UTZ

-26-

Instructions for Form 8933 (Rev. 12-2022)

Instructions for Form 8933 (Rev. 12-2022)
Location of
capture facility
(county, state)

EPA
e-GGRT ID
number(s)*
Check if supplier supplied any
nonqualified carbon oxide

-27-

* if available

Total

4

(F) Metric
(E) Metric
(G) Metric
tons of
tons of
tons of
qualified
qualified
qualified
carbon oxide
carbon
carbon
delivered to
oxide
oxide
utilization
utilized
utilized
facility

(H) Metric
tons of
carbon oxide
delivered to
utilization
facility (add
columns (B),
(D), and (F))

Total nonqualified carbon
oxide from all suppliers

Model Certificate UTZ

(M) Metric tons of
carbon oxide
utilized (add
columns (I) and
(K))

Sum for all carbon oxide suppliers

(L) Metric tons
(I) Metric
(J) Metric tons
of carbon
tons of
of carbon
(K) Metric
oxide delivered
carbon oxide
oxide
tons of
to utilization
utilized (add
delivered to carbon oxide
facility (add
columns (C),
utilization
utilized
columns (H)
(E), and (G))
facility
and (J))

Total qualified carbon oxide
from all suppliers

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3

2

1

(B) Metric
(D) Metric
(C) Metric
tons of
tons of
(A) Owner or
tons of
qualified
qualified
lessee of
qualified
carbon oxide
carbon oxide
utilization
carbon
delivered to
delivered to
facility
oxide
utilization
utilization
utilized
facility
facility

Name of qualified carbon Name of qualified carbon Name of qualified carbon
oxide supplier 1
oxide supplier 2
oxide supplier 3

10 Attach a copy of the LCA approval letter from the IRS. Don’t file this model certificate if you haven’t received the approval letter.
Table 3 — Information About Utilization

9

Complete Table 3 below using information that conforms to the Life Cycle Assessment (LCA) that was approved by the Department of Energy and the IRS. If there are more than four owners of the
utilization facility or three suppliers of qualified carbon oxide, prepare a separate table with all information and attach it to this model certificate.
Check here to attest that all figures in Table 3 conform to the LCA that was subject to a technical review by the DOE, and approved by the IRS . . . . . . . . . . . . . . . . . . .

Name of capture facility

8

EIN

List all suppliers of nonqualified carbon oxide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Name

7

3

2

1

Qualified carbon oxide
supplier

Section 2—Information about the qualified carbon oxide supplied to the utilization facility:
6 In Table 2, provide information about all suppliers of qualified carbon oxide during the calendar year. “Qualified” carbon oxide means carbon oxide from a supplier who attests that the carbon oxide
was captured at one of its qualified 45Q facilities. “Supplier” means the person who captured the qualified carbon oxide, which may differ from the company that sold the carbon oxide or physically
delivered the carbon oxide to the owner of the utilization facility. If there are more than three suppliers of qualified carbon oxide to the utilization facility, prepare a separate table with all information
and attach it to this model certificate.
Table 2 — Information About Suppliers of Qualified Carbon Oxide

Part I. Information About the Qualified Carbon Utilization Facility and Utilization of Carbon Oxide (continued)

Page 2

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If the total for column (H) is less than 25,000 metric tons, have you verified with the supplier that its facility meets the minimum capture requirements?

Project or LCA number assigned by the DOE

Date (MM/DD/YYYY) approval letter for the utilization facility was received from the IRS

Attach a copy of the approval letter from the IRS.
State if you are applying the TD or the NPRM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3

4

5
6

. . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date (MM/DD/YYYY) the LCA was submitted to the DOE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Title of the LCA submitted to the Department of Energy (DOE)

1

Part II. Information About the Life Cycle Assessment (LCA) and This Claim

11

Part I. Information About the Qualified Carbon Utilization Facility and Utilization of Carbon Oxide (continued)
. . . . . . . . . . . . . . .

No

Model Certificate UTZ

Yes

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Instructions for Form 8933 (Rev. 12-2022)

EIN

3

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Instructions for Form 8933 (Rev. 12-2022)

Name and location of qualified carbon oxide capture facility (if supplier supplied any qualified carbon oxide) . . . . . . . . . . . . . . . . .

Type of industrial facility at which the supplier captured its qualified carbon oxide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Check here if you were one of the suppliers. Don’t check unless the EIN of the supplier of the qualified carbon oxide is the same as your EIN. If the EINs aren’t
the same, there must be a binding written contract between the entities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Unless line 8 is checked, do you attest that a binding written contract between you and the supplier exists that ensures that you will utilize its qualified carbon oxide in the
manner required under section 45Q(f)(5) and the underlying regulations? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Provide the date (MM/DD/YYYY) of the contract referenced in the line above or the date of the most recent contract amendment . . . .

Metric tons of qualified carbon oxide received from the supplier during the year and used in the process indicated on line 6 (metric tons
should agree with the figure reported in Table 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Metric tons of the supplier's qualified carbon oxide, expressed as carbon dioxide equivalent, utilized in your facility and determined by an
LCA (metric tons should agree with the figure reported in Table 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Metric tons of the supplier's nonqualified carbon oxide, expressed as carbon dioxide equivalent, utilized in your facility and determined by
an LCA (metric tons should be part of the figure in Table 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Check here if you attest that the supplier of qualified carbon oxide elected to allow you to claim some or all of the carbon oxide sequestration credit attributable
to their qualified carbon oxide. Attach a copy of Model Certificate ELECT signed by both you and the supplier for this year . . . . . . . . . . . . . . . . . . . . . .

6

7

8

10

11

-29-

14

13

12

9

Supplier's EIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5

No

Model Certificate UTZ

Yes

Section 2—Information about all suppliers of qualified carbon oxide to you. Complete multiple model certificates if you had more than one supplier of qualified carbon oxide:
4 Supplier's name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address

2

Section 1—Information about you, the owner or lessee of the utilization project:
1 Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Part III. Information About You and Each of Your Suppliers of Qualified Carbon Oxide

Utilization Certification (continued)

Page 4

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Company's name and EIN

Title

Printed or typed name of person signing this report

Signature and date signed

Model Certificate UTZ

Under penalties of perjury, I attest that I am an officer of the company that is the owner of the subject utilization project. I further attest that the above information is true and correct and that I have
provided a signed copy of this completed certificate to each person who supplied qualified carbon oxide to my company for use at the subject utilization facility during this year.

Utilization Certification (continued)

Page 5

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Instructions for Form 8933 (Rev. 12-2022)

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Model Certificate ELECT
Election Certification

2022

Name(s) shown on return:

Identifying number:

Part I. Information About Electing Taxpayer and Credit Claimant
Section 1—Electing taxpayer's information from Model Certificate CF:
1 Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Address
3 TIN

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4 Location of capture facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 Placed-in-service date of carbon capture equipment. See Rev. Rul. 2021-13, 2021-30 I.R.B. 152
6 Type of industrial facility

. .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7 EPA e-GGRT ID number(s)* of each qualified facility where carbon oxide was captured . . . . . . . . .
Section 2—Information about the credit claimant. Complete a separate Model Certificate ELECT for each credit claimant (see
instructions):
8 Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9 Address
10 TIN

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11 Do you attest that the credit claimant isn’t a subcontractor? If you can’t answer “Yes,” you can’t elect to allow the credit claimant to
claim any of your credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

No

12 Check which statement applies:
a
Credit claimant disposed of qualified carbon oxide in secure geological storage and didn’t use it as a tertiary injectant in a qualified
enhanced oil or natural gas recovery project, nor utilized it in a way described in section 45Q(f)(5).
b
Credit claimant disposed of qualified carbon oxide in secure geological storage and used it as a tertiary injectant in a qualified enhanced
oil or natural gas recovery project.
c
Credit claimant utilized qualified carbon oxide in a way described in section 45Q(f)(5).
13 Location of disposal site if box 12a or 12b was checked . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14 EPA e-GGRT ID number(s)* of each disposal site if box 12a or 12b was checked . . . . . . . . . . . . .
15 Check which statement applies:
a
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility before February 9,
2018, disposed of in secure geological storage, and not used as a tertiary injectant in a qualified enhanced oil or natural gas recovery
project, nor utilized in a way described in section 45Q(f)(5).
b
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility before February 9,
2018, disposed of in secure geological storage, and used as a tertiary injectant in a qualified enhanced oil or natural gas recovery
project.
c
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility before February 9,
2018, and utilized as described in section 45Q(f)(5).
d
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9,
2018, during the 12-year period beginning on the date the equipment was originally placed in service, disposed of in secure geological
storage, and not used as a tertiary injectant in a qualified enhanced oil or natural gas recovery project, nor utilized as described in
section 45Q(f)(5).
e
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9,
2018, during the 12-year period beginning on the date the equipment was originally placed in service, disposed of in secure geological
storage, and used as a tertiary injectant in a qualified enhanced oil or natural gas recovery project.
f
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9,
2018, during the 12-year period beginning on the date the equipment was originally placed in service, and utilized as described in
section 45Q(f)(5).
16
If box 15a, 15b, or 15c was checked, check here if you elect to claim the credit rates for equipment placed in service prior to the
enactment of the Bipartisan Budget Act of 2018.
17 Check the correct credit rate that applies for 2022 based on the boxes checked for lines 12, 15, and 16.
a
$25.07 ($20 plus inflation for old equipment)
b

$12.53 ($10 plus inflation for old equipment)

c

$37.85 for new equipment and qualified carbon oxide disposed of in secure storage and not used in EOR

d

$25.15 for new equipment and qualified carbon oxide disposed of in secure storage and used in EOR or utilized in a manner described
in section 45Q(f)(5)

* if available
Model Certificate ELECT

Instructions for Form 8933 (Rev. 12-2022)

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Page 2

Election Certification (continued)
Part II. Election Information
1 If box 12a was checked, metric tons of qualified carbon oxide captured by the Electing Taxpayer and
disposed of in secure geological storage by the Credit Claimant and not used as a tertiary injectant in a
qualified enhanced oil or natural gas recovery project, nor utilized it in a way described in section 45Q(f)
(5) (metric tons should agree with the amount on Model Certificate DISP-Owner, line 12) . . . . . . . .
2 If box 12b was checked, metric tons of qualified carbon oxide captured by the Electing Taxpayer and
disposed of in secure geological storage by the Credit Claimant and used as a tertiary injectant in a
qualified enhanced oil or natural gas recovery project (metric tons should agree with the amount on
Model Certificate EOR-Owner, line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 If box 12c was checked, metric tons of the Electing Taxpayer's qualified carbon oxide, expressed as
carbon dioxide equivalent, utilized in the Credit Claimant's facility and determined by an LCA (metric
tons should agree with the amount in Model Certificate UTZ, Part III, line 12) . . . . . . . . . . . . . . . .
4 Metric tons of qualified carbon oxide listed on line 1, 2, or 3, allowed by electing taxpayer to be claimed
by the credit claimant. Based upon the box checked in Part I, line 15, electing taxpayer adds this
amount to Model Certificate CF, Part II, column (a) of line 1e, 2e, or 3e, or Part III, column (a) of line 4e,
5e, or 6e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 2022 credit rate from line 17 of Part I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Multiply line 4 by line 5. Carbon oxide sequestration credit allowed by electing taxpayer to be claimed by
the credit claimant. Credit claimant adds this amount to its Form 8933, line 13 . . . . . . . . . . . . . . .
7 Subtract line 4 from amount listed on lines 1, 2, or 3. Metric tons of qualified carbon oxide not allowed by
electing taxpayer to be claimed by the credit claimant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8 Multiply line 7 by line 5. Carbon oxide sequestration credit retained by the electing taxpayer . . . . . .
Under penalties of perjury, I attest that I am an officer of the company that is the owner of carbon capture equipment described in Part I, lines 1
through 7. I further attest that the above information is true and correct.

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN

Under penalties of perjury, I attest that I am an officer of the company that is the owner of the carbon oxide disposal, use, or utilization site described
in Part I, lines 8 through 12. I further attest that the above information is true and correct.

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN

Model Certificate ELECT

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Model Certificate RECAPTURE
Recapture Certification

2022

Name(s) shown on return:

Identifying number:

Part I. Information About the Geologic Disposal Site
Section 1—Information about the owner(s) of the geologic disposal site:
Table 1 — Information About the Owner(s) of the Geologic Disposal Site
1
2022
Name, EIN,
and address

2021
Operating
interest (%)

Name, EIN,
and address

2020

Operating
interest (%)

Name, EIN,
and address

2019
Operating
interest (%)

Name, EIN,
and address

Operating
interest (%)

Owner A
Owner B
Owner C
Owner D
All other
owners.
Attach a
complete
table on
a
separate
sheet.
Section 2—Information about the geologic disposal site or EOR project for 2022:
2
Indicate if the project is a geologic disposal site (without EOR) or an EOR project

. . . . . . . . . . . . . .

3

Name and location (county and state) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4

6

List the name and EIN of the person who, for purposes of Regulations section 1.45Q-2(h), is the operator
of the project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
List any other companies that are identified as the operator of the project for any other purpose(s) and the
nature of the purpose(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
EPA e-GGRT ID number(s)* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7

When did injection of captured carbon oxide begin (MM/YYYY)? . . . . . . . . . . . . . . . . . . . . . . . . .

8

If the EOR project was previously certified under section 43, state the name of the certified project and the
date (MM/DD/YYYY) of the petroleum engineer's certification . . . . . . . . . . . . . . . . . . . . . . . . . . .
If the EOR project wasn’t previously certified under section 43, attach a copy of a valid petroleum engineer's certification to this Model
Certificate RECAPTURE.
Yes
No
Is this EOR project an enhanced natural gas recovery project? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5

9

10

11–15 Reserved for future use.
16 If the amount of sequestered carbon oxide has been determined pursuant to 40 CFR Part 98 subpart RR, attach a copy of the approved
MRV plan or provide the URL of it on the EPA's website.
17 If the amount of sequestered carbon oxide has been determined pursuant to ISO 27916, attach a copy of the ISO 27916 documentation for
the calendar year. Also attach a copy of the certification by a qualified independent engineer or geologist.
* if available
Model Certificate RECAPTURE

Instructions for Form 8933 (Rev. 12-2022)

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Page 2

Part II. Determination of Recaptured Qualified Carbon Oxide
1 List the total metric tons of qualified carbon oxide securely stored in the geologic disposal site or EOR project during
2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Metric tons of qualified carbon oxide that, during 2022, the owner, operator, or regulatory agency determined has leaked
from the containment area of the reservoir during 2022 or previous calendar years if not previously accounted for . . . . .
3 Metric tons of qualified carbon oxide that, during 2022, the owner, operator, or regulatory agency determined has leaked
from the containment area of the reservoir during 2022 or previous calendar years if not previously accounted for, and will
eventually migrate to the atmosphere . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 If line 3 is less than line 2, attach a statement explaining how you determined that the qualified carbon oxide won’t eventually
migrate to the atmosphere.
5 Subtract line 1 from line 3. If greater than zero, a recapture event has occurred. This is the qualified carbon oxide subject to
recapture. See Regulations section 1.45Q-5(d). Complete the remainder of Part II. Don’t complete this model certificate if a
recapture event didn’t occur . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Attach a statement describing the cause of the leakage of qualified carbon oxide.
7 Which regulatory agencies were made aware of the leakage of qualified carbon oxide? . . . . . . . . . . . . . . . . . . . . . .
8 Attach a copy of Model Certificate DISP-Operator or Model Certificate EOR-Operator for this disposal site for each of the previous THREE
calendar years.
9 Complete Table 2 below.
10 In column (C), list the amount of total carbon oxide stored in each of the THREE calendar years prior to the current calendar year. This would be
from Model Certificate EOR-Operator, Table 3, column (M), row (5), for each year.
11 In columns (E), (F), (G), (H), and (I), allocate the amount in column (D) to each owner of the geologic disposal site or EOR project for each year.
Check the box if the carbon oxide was qualified. Use two columns for any owner that stored both qualified and nonqualified carbon oxide. If
more columns are needed, attach a separate table that shows the allocation for all owners. You should allocate the amount of stored carbon
oxide on a pro rata basis, using figures from Model Certificate EOR-Operator, Table 3, of each year, unless there is a sound engineering basis
to do otherwise.
12 Check here if the allocation of the amounts in column (D) were done in a manner other than pro rata and attach an explanatory
statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Table 2 — Information About Stored Carbon Oxide Subject to Recapture

(A)
Year
prior

(C)
Metric
tons of
stored
carbon
oxide
(D) Stored
from
carbon oxide
(B)
Table 3
subject to
Year
of the
recapture*
applicable
Operator
Certificate
for the
indicated
year

(1) 1st

2021

(2) 2nd

2020

(3) 3rd

2019

Allocation of stored carbon oxide subject to recapture
Owner
name
and EIN

(E)

(F)

(G)

(H)

(I)

(J)

(K)

Reserved
for future
use

Total. Add
columns (E)
through (I)

Check if
carbon
oxide
was
qualified
carbon
oxide

(4) Total. Add
rows (1)
through (3).
(5) Subtract Part II, line 5,
from column (D), row
(4). Metric tons of
carbon oxide not subject
to recapture due to
look-back being limited
to THREE calendar
years.
13 Provide a copy of Parts I and II to each owner of the disposal site or EOR project during the current and THREE previous calendar years.
Model Certificate RECAPTURE

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Page 3

Recapture Certification (continued)
Under penalties of perjury, I attest that I am an officer of the company that is the operator of the subject geologic disposal site or the subject EOR
project or have been designated by the operating interest owners to prepare and submit this certificate to the IRS on their behalf. I further attest that
the above qualified carbon oxide sequestration credit recapture information is true and correct.

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN

Part III. Determination of Recaptured Qualified Carbon Oxide for Supplier
Part III will be prepared by each owner of the disposal site or EOR project during the current and THREE previous calendar years. Part III will be
used to determine the amount of qualified carbon oxide sequestration credit that needs to be recaptured. A separate Part III should be completed for
each supplier of qualified carbon oxide during the current and THREE previous calendar years and a copy should be given to each supplier.
Information about you, the owner of the EOR project:
1 Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Address
3 EIN

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Information about suppliers who supplied carbon oxide during any of the THREE previous calendar years. COMPLETE A PART III FOR
EACH SUPPLIER:
4 Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 EIN

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6 Name and location of carbon oxide capture facility (if supplier supplied any qualified carbon oxide) . . . . . .
7 Type of industrial facility at which the supplier captured its qualified carbon oxide . . . . . . . . . . . . . . . . .
8 Complete Table 5 using information from Table 3 of Model Certificate EOR for the previous THREE calendar years. Complete a separate Table
5 for each supplier of qualified carbon oxide during the previous THREE calendar years. If one supplier supplied qualified carbon oxide from
multiple facilities, complete a Table 5 for each facility.

Model Certificate RECAPTURE

Instructions for Form 8933 (Rev. 12-2022)

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Recapture Certification (continued)
Table 5 — Information About Carbon Oxide Sequestration Credit Subject to Recapture by Supplier
Supplier Name:

(A)
Year
prior

(C) Total
metric
tons of
(B)
stored
Year carbon
oxide
from
Table 2

(1)

1st

2021

(2)

2nd

2020

(3)

3rd

2019

(D) Total
metric tons of
stored carbon
oxide subject
to recapture

(E) Your
amount of
qualified
carbon
oxide
subject to
recapture

(H) Amount
of carbon
oxide
sequestration
(G) Metric tons of
credit for
carbon oxide for
which the
(F) Rate of
which the
supplier
carbon oxide supplier elected
elected to
sequestration
to allow you to
allow you to
credit for the claim the carbon
claim the
year ($/MT)
oxide
carbon oxide
sequestration
sequestration
credit (MT)
credit ($).
Multiply
column (G)
by column
(F).

(I) Metric tons
(J) Amount of
of carbon oxide carbon oxide
for which the
sequestration
supplier didn’t credit for which
elect to allow
the supplier
you to claim
didn’t elect to
the carbon
allow you to
oxide
claim the
sequestration
carbon oxide
credit (MT).
sequestration
Subtract
credit ($).
column (G)
Multiply
from column
column (I) by
(E).
column (F).

(4) Total metric tons. Add rows (1) through (3) . . . . . . . . . . . . . . . .
(5) Amount of carbon oxide sequestration credit you must recapture this year for carbon
oxide supplied by this supplier. Add rows (1) through (3). Add to your Form 8933, Part V,
line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(6) Total metric tons. Add rows (1) through (3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(7) Amount of carbon oxide sequestration credit the supplier of carbon oxide must recapture this year. Add rows (1) through
(3). The supplier must add this amount to its Form 8933, Part V, line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Under penalties of perjury, I attest that I am an officer of the company that is the owner of the subject geologic disposal site or the subject EOR
project. I further attest that the above information is true and correct and that I have provided a signed copy of this completed recapture certificate to
each person.

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN

Model Certificate RECAPTURE

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Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the
United States. You are required to give us the information. We need it to ensure that you are complying with these laws
and to allow us to figure and collect the right amount of tax.
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be
retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax
returns and return information are confidential, as required by section 6103.
The time needed to complete and file this form will vary depending on individual circumstances. The estimated burden
for individual and business taxpayers filing this form is approved under OMB control number 1545-0074 and 1545-0123
and is included in the estimates shown in the instructions for their individual and business income tax return. The
estimated burden for all other taxpayers who file this form is shown below.
Recordkeeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 hr., 43 min.
Learning about the law or the form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 hr., 9 min.
Preparing and sending the form to the IRS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 hr., 39 min.

If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler,
we would be happy to hear from you. See the instructions for the tax return with which this form is filed.

Instructions for Form 8933 (Rev. 12-2022)

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