Form 8933 Schedule Disposal Operator Certification

Schedule B
(Form 8933)

Disposal Operator Certification

(December 2024)

OMB No. 1545-0123

Attach to Form 8933.
Go to www.irs.gov/Form8933 for instructions and the latest information.

Department of the Treasury
Internal Revenue Service

Identifying number

Name(s) shown on return

Part I
1

Information About the Owner(s) of the Geological Disposal Site

Provide information about each owner of the disposal site during the calendar year.
• If there are more than four owners, prepare a separate schedule with all the owner information and attach it to this schedule.
• If one or more of the owners is a partnership or an S corporation, provide information about the pass-through entity, not about the 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 about all such owners.
(i) Disposal site owner

(ii) Address

(iii) Employer
identification
number (EIN)

(iv) Operating
interest (%)

A
B
C
D

Part II

Information About the Geological Disposal Site

2

Name and location (county and state, or offshore tract)

4

Other company(ies) identified as the operator of the project for any other purpose(s) and the nature of the purpose

5a

IRS-issued registration number(s) for the geological
disposal facility

7

Check here to declare that all figures of stored carbon oxide on this schedule 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 . . . . . . . . . . . . . . . . . . . . . . . . . . .
Attach a copy of the approved MRV plan or provide the URL where it can be viewed on the EPA website.

8

Part III
9

3

5b

Name and EIN of the operator of the site

Geological disposal site’s EPA e-GGRT ID number(s),
if available

6

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

Information About the Qualified Carbon Oxide Supplied to the Geological Disposal Site and Securely Stored

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 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 geological disposal site.

(i) Qualified carbon
oxide supplier

(ii) EIN

(iii) Name and location of capture facility
(county and state)

(iv) IRS-issued
registration number

(v) EPA’s e-GGRT ID
(if any)

(vi) Check if
supplier
supplied any
nonqualified
carbon oxide
from any
source

A
B
C
For Paperwork Reduction Act Notice, see the Instructions for Form 8933.

Cat. No. 94873R

Schedule B (Form 8933) (12-2024)

Page 2

Schedule B (Form 8933) (12-2024)

Part III
10

Information About the Qualified Carbon Oxide Supplied to the Geological Disposal Site and Securely Stored (continued)

Provide disposal information consistent with all applicable EPA filings. If there are more than four owners of the geological disposal site or suppliers of qualified carbon
oxide, prepare a separate schedule with all the supplier information and attach it to this schedule.
Qualified Carbon Oxide Supplier
(a) Geological disposal
site owner

(i)

(ii)
(b) Metric tons
delivered

A
B
C
D
Total

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(d) Metric tons
delivered

(e) Metric tons
stored

(f) Metric tons
delivered

(g) Metric tons
stored

.

(iv) Total qualified carbon oxide
from all suppliers
(h) Metric tons delivered
(add columns (b), (d), and (f))

(c) Metric tons
stored

(iii)

(i) Metric tons stored
(add columns (c), (e), and (g))

(v) All other suppliers of
nonqualified carbon oxide
(j) Metric tons delivered

(vi) Total metric tons
for all carbon oxide suppliers

(k) Metric tons stored

(l) Metric tons delivered
(add columns (h) and (j))

(m) Metric tons stored
(add columns (i) and (k))

A
B
C
D
Total
11

Check here to attest that all information provided on line 10 conforms to all applicable EPA filings

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Schedule B (Form 8933) (12-2024)