Form 637 and Questionnaires

Name:		EIN:
Address:		637 Reg No.:
City, State, Zip:		OMB No.:	1545-1835

In addition to the Form 637 General Questionnaire, please answer the following questions specific to this activity. (Attach additional sheets, if needed.)

Activity Letter AB: Producers and importers of agri-biodiesel.

See Notice 2005-04, 2005-1 C.B. 289, 2(f).

These persons are required to be registered under IRC 4101(a)(1) and Notice 2005-04.

To ensure Form 637 Registration compliance, the IRS will periodically obtain samples of biodiesel produced or imported to ensure the registration requirements for fuel and fuel additives established by Environmental Protection Agency under section 211 of the Clean Air Act (42 U.S.C. 7545) and the requirements of the American Society of Testing and Materials are met.

"AB" QUESTIONNAIRE

1. Does your business qualify for the Form 637 “AB” Registration?

☐Yes ☐ No

• If yes, please complete questions below and return this form.

• If no, please sign the statement below, date, and return this form.

I request that my Form 637 “AB” Registration be denied or revoked as I am no longer engaged in this activity.

____________________________________ __________________

Printed Name Title

____________________________________ __________________

Signature Date

Note: This request must be signed by a person with authority to bind the applicant or registrant. Refer to Form 637, Application for Registration (For Certain Excise Tax Activities), General Instructions, under the Signature section for additional guidance.

1. Is your business currently using your business’s registration to produce and/or import agri-biodiesel?

☐Yes ☐No

If yes, when was the last time that your business produced and/or imported agri-biodiesel?

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   Does your business plan to continue using your business’s registration to produce and/or import agri-biodiesel?

☐Yes ☐No

If yes, give a brief description of your business’s plans for producing and/or importing agri-biodiesel.

4. 
   
   

   
   
   

   
   
   

   
   
   

   Check the box(es) representing activities in which your business is engaged.

☐Producer

☐Importer

5. Has your business’s agri-biodiesel been tested to determine if it meets the ASTM D6751 standard for agri-biodiesel?

☐Yes ☐No

If yes, please provide a copy of the latest independent third party certificate of analysis performed on your business’s agri-biodiesel that certifies the ASTM D6751 standard has been met.

6. Does your business blend the agri-biodiesel that you produce or import with petroleum diesel?

☐Yes ☐No

If yes, please list all blend percentages (e.g., (B5 (5% Bio), B20 (20% Bio), B99.9 (99.9% Bio), etc.).

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   List the type and annual volume (in gallons) of agri-biodiesel produced and/or imported.

   Type of Agri-Biodiesel	Annual Volume (gallons)

8. List the name and address of all feedstock suppliers, include the type and annual volume of product purchased (e.g., soybean, sunflower seeds, canola, flaxseeds, etc.).

   Name and Address of Supplier	Type of Feedstock Purchased	Expected Annual Volume Purchased

9. List the name and address of methanol suppliers, include the annual volume of product purchased.

   Name and Address of Supplier	Expected Annual Volume Purchased

10. List all locations of storage facilities where feedstock, produced/imported agri-biodiesel, and/or products used in blending are stored. Include a description of the product (e.g., Soybean - feedstock, Diesel - blending component, and B99 - finished product).

    Product & Description	Name and Address of Facility	Fuel Tank Capacity (Gallons)	Expected Annual Volume

11. Does your business use agri-biodiesel as a fuel?

☐Yes ☐No

If yes, how is the product being used?

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    Does your business sell agri-biodiesel as a fuel?

☐Yes ☐No

If yes, list the customer and type of product/blend being sold (B100, B99, B20).

Customer Name	Product/Blend

13. Please list all production agreements that your business has, or plans to implement within the year.

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    Does your business store any agri-biodiesel to which it does not hold title?

☐Yes ☐No

If yes, where is this inventory stored, and for whom is it stored? Are separate inventory records maintained? Who is filing claims for the production or importation of the fuel?

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    Does your business sell or plan to sell any agri-biodiesel to a related company?

☐Yes ☐No

If yes, describe the arrangements.

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    Does your business sell agri-biodiesel on consignment?

☐Yes ☐No

If yes, where is this inventory stored and whom is it stored for? Are separate inventory records maintained? Who is filing claims for the production or importation of the fuel?

17. Does your business export or plan to export any agri-biodiesel product?

☐Yes ☐No

If yes, please explain.

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    Does your business own fuel transports?

☐ Yes ☐ No

If yes, list Vehicle Identification Number (VIN), Gross Vehicle Weight (GVW), fuel transported and capacity of each.

VIN	GVW	Fuel Transported	Capacity

19. List the name and phone number of a person whom we can contact about this application/registration.

Form 637 AB Questionnaire 4 Revised Feb 2022