5900-538 American Innovation and Manufacturing Act - HFC Sale or

				OMB Control Number: 2060-0734
				Expiration Date: 12/31/2024
	American Innovation and Manufacturing Act - HFC Sale or Conveyance Report
	Worksheet Instructions:
	Complete and submit an HFC Sale or Conveyance Report if your company (seller) would like to sell or convey HFCs produced or imported by expending application-specific allowances to another company (purchaser) within the same application. All sections of the report must be completed prior to submission. The seller and the purchaser may proceed with the sale or conveyance when EPA issues a non-objection notice.
	Version:
	r0.2
	Updated:
	2/18/2022
	External Links:
	HFC Allocation Rule Reporting HelpDesk		AIM Act Paperwork Reduction Act Burden
	Reporting Form Navigation:
	Section 1 - Application-Specific Seller Identification
	Section 2 - Application-Specific Purchaser Identification
	Section 3 - Transaction Information
	EPA may request additional information or ask follow up questions to verify the accuracy of this submission and supporting documentation, including pursuant to CAA section 114 as authorized under the AIM Act.
	Section 1 - Application-Specific Seller Identification
	Instructions: Complete the following company information.
	Company Name:
	Company ID:
	Section 2 - Application-Specific Purchaser Identification
	Instructions: Complete the following company information.
	Purchaser Company Name:
	Purchaser Company ID:
	Section 3 - Transaction Information
	Instructions: Provide the following information for each HFC produced or imported using application-specific allowances that is being sold or conveyed. In addition, provide a certification that the HFCs will be used only for the same application for which the application-specific allowance under which the substances were produced or imported was allocated. §84.21(a)(2)(vi)
	Transaction Data
	1	2	3	4
	HFC	Quantity Sold or Conveyed (kg) §84.21(a)(2)(iii)	Total Cost of the HFC being Sold or Conveyed (USD) §84.21(a)(2)(iv)	Application for Which Allowances Were Allocated §84.21(a)(2)(v)
1
2
3
	Should the certification that the HFCs will be used only for the same application for which the application-specific allowance under which the substances were produced or imported was allocated be treated as confidential business information (CBI)?
	Provide the specific products that the application-specific purchaser plans to produce with the HFCs. §84.21(a)(2)(v)
	This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0734). Responses to this collection of information are mandatory (40 CFR 84.21). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The public reporting and recordkeeping burden for this collection of information is estimated to be 6 hours per response. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden including through the use of automated collection techniques to the Director, Regulatory Support Division, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.
	EPA Form # 5900-538