5900-556 American Innovation and Manufacturing Act - HFC Importer

						OMB Control Number: 2060-0735
						Expiration Date: 4/30/2022
American Innovation and Manufacturing Act - HFC Importer of Record Report
Worksheet Instructions:
Submit this cover sheet along with any supporting documentation to EPA through the ODS Tracking System (ODSTS). Instructions on how to report data through the ODSTS are available at <https://www.epa.gov/ods-phaseout/submitting-other-documents-epa>. Select "HFC Importer of Record" as the document type when submitting your documentation.
Version:
1.1
Updated:
11/18/2021
Reporting Form Navigation:
Section 1 - Company Identification
Section 2 - Plan for importing HFCs
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 - Company Identification
Instructions: Complete the following company information for each importer of record under common control or that is a subsidiary of the allowance holder. Please provide the Importer of Record Name and Number for each company that intends to import using your company's allowances.
Allowance Holder Name:
Reporting Year:
	Importer 1	Importer 2	Importer 3	Importer 4	Importer 5
Importer of Record - Name:
Importer of Record - Number:
Section 2 - Plan for Importing HFCs
Instructions: Identify the single component HFC(s) your company commonly imports and expects to import in the coming year and the CAS number for each.
Intended HFC Imports
HFC	CAS Number
Instructions: Identify the HFC blends your company commonly imports and expects to import in the coming year, and the ASHRAE numerical designation of the refrigerant or the percentage of the mixture containing each regulated substance and the CAS numbers for each neat HFC.
Intended HFC Blend Imports
HFC Blend	HFC Component (1)			HFC Component (2)			HFC Component (3)
	HFC	HFC Composition of Blend (%)	CAS Number	HFC	HFC Composition of Blend (%)	CAS Number	HFC	HFC Composition of Blend (%)	CAS Number
Instructions: Identify the HTS codes for the HFCs and HFC blends your company commonly imports and expects to import in the coming year.
HTS Codes
Instructions: Identify the types of cylinders commonly used to import HFCs and HFC blends.
Cylinder Information
Description		Typical Range of Mass (kg) Contained in Each Cylinder
Instructions: Identify the ports of entry through which your company expects to import HFCs and HFC blends in the coming year.
Commonly used Ports of Entry
This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0735). Responses to this collection of information are voluntary. 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 2 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 # 5900-556