Annual Performance Report and Certification of Section 1603

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Nevelyn.Jones@Do.Treas.gov
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lorenl2@gmail.com - Session
time: 40:03

Application for Section 1603:

Payments for Specified Renewable Energy Property in Lieu of Tax Credits
ANNUAL PERFORMANCE REPORT AND CERTIFICATION
OMB Control Number 1505-0221

The Annual Performance Report and Certification must be submitted annually, 21 calendar days after the date the property was placed in service, e.g., if the property was
placed in service on January 10, 2011, the first report and certification are due January 31, 2012. The report covers a one-year period beginning on the placed in service
date. Subsequent reports cover a one-year period beginning on the day after the last day covered by the prior year's report.
The Annual Performance Report and Certification is required on an annual basis for a period of five years after the energy property was placed in service.
Failure to supply the Annual Performance Report and Certification as required by the Terms and Conditions signed under penalty of perjury will result in recapture of the funds
received.

Year: 1 TAN: 2012E48SE206617

Section 1 - Disposition of the Property

1.1. Has the energy property (for example: solar panels, wind turbine) been sold during this year?
No
Yes
1.2. Date of sale:

1.3. Is the purchaser one of the following?
• A Federal, State or local government or any political subdivision, agency or instrumentality thereof;
• Any organization described in section 501(c) of the Internal Revenue Code and exempt from tax under section 501(a) of such Code;
• Any entity referred to in paragraph (4) of Section 54(j) of the Internal Revenue Code;
• Any partnership or pass-thru entity any partner (or other direct or indirect holder of an equity or profits interest) of which is a Federal, State or local
government or any political subdivision, agency or instrumentality thereof, an organization described in section 501(c) of the Internal Revenue Code and
exempt from tax under section 501(a) of such Code, or an entity referred to in paragraph (4) of Section 54(j) of the Internal Revenue Code
No
Yes
1.4. Did the purchaser agree in a written agreement to be jointly liable with the applicant for any recapture (see Guidance page 20)?
No
Yes
1.5. Attach the written agreement:
Browse...
ACCEPTED FILE TYPES: Office (doc, docx, xls, xlsx), comma separated value (csv), Adobe Portable Document Format (pdf), and plain text (txt) formats. Limit total size
of all files to 100 MB or less.
If you require more uploads than this form provides, supplement these with the “Add/Modify Supporting Documentation” function under the
Application Control Panel for this application when finished.

Section 2 - Owner Information (This information is about the current owner of the energy property.)

2.1 Current/New Owner Entity
Business Name:
Phone:

Street address 1:

000 000 0000 [()-

Street address 2 (optional):

.]
Employer Identification Number
(EIN):

000000000

DUNS Number:

000000000

Website address (optional):

City:
State: ...
Zip code:

00000[-0000]

2.2. Has the entity that owns the energy property or any interest in entity that owns the energy property been sold or transferred?
No
Yes
2.2.0. Date of sale or transfer:

2.2.1. Is the purchaser or transferee any of the following?

•
•
•
•

A Federal, State or local government or any political subdivision, agency or instrumentality thereof;
Any organization described in section 501(c) of the Internal Revenue Code and exempt from tax under section 501(a) of such Code;
Any entity referred to in paragraph (4) of Section 54(j) of the Internal Revenue Code;
Any partnership or pass-thru entity any partner (or other direct or indirect holder of an equity or profits interest) of which is a Federal, State or local
government or any political subdivision, agency or instrumentality thereof, an organization described in section 501(c) of the Internal Revenue Code and
exempt from tax under section 501(a) of such Code, or an entity referred to in paragraph (4) of Section 54(j) of the Internal Revenue Code

No
Yes
2.3. Current/New Owner Point of Contact of the specified energy property:
First name:

Last name:

Organizational affiliation:

E-mail address:

Phone:

Fax:

000 000 0000 [().]

000 000 0000 [().]

2.4 Has the owner of the energy property filed for bankruptcy?
No
Yes
2.4.1. Date bankruptcy filed:

2.4.2. Court and Docket Number:

2.4.3. Describe the outcome or current status of the bankruptcy including disposition of the energy property, if applicable:

Limit to 1,000 characters

Section 3 - Property Information

3.1. Has a tax credit (section 45 or 48 of the Internal Revenue Code) been claimed for this energy property? (This does not mean the 1603
payment.)
No
Yes
3.2. Was the energy property located outside of the United States except as described in section 168(g)(4) of the IRC?
No
Yes
List the amount of time that the specified energy property was located outside of the United States within the last year. (United States means the contiguous states,
Alaska and Hawaii):
Percentage of use outside U.S.:
%
3.3. Has the name of the project changed from the one shown below?
No
Yes
Project Name:
Explain the change:

Limit to 1,000 characters

3.4. Has the location of the energy property changed from the location shown below?
No
Yes
Street Address 1:
*City:
Street Address 2 (optional):
State: ...

*County:
Zip Code:

Explain the change(s):

Limit to 1,000 characters

Section 4 - Energy Production

4.0 Has the energy property, as of the date of this report, stopped producing energy?
No
Yes
4.0.1 Are any actions being taken to cause the energy property to resume producing energy?
No

00000[-0000]

Yes
Describe actions being taken to cause the energy property to resume producing energy:

Limit to 1,000 characters

4.1. Annual Production — Enter the actual annual production in the past year of the energy property in kilowatt hours, MMBTUs, or horsepower, as applicable.
NOTE: Leave blank for solar thermal (less than 0.1 MMBTU/hr), solar lighting, or geothermal heat pump.
Electrical
Mechanical
Thermal
Annual production:

kW
kWh

hp
MMBTU

MMBTU

4.1.1. Is this year’s annual production less than the estimated annual production entered in section 4D of the application?
No
Yes
Explain the reduced annual production this year:

Limit to 1,000 characters

4.1.2. Has any “unit of property” been replaced or permanently ceased to produce energy? For purposes of this question a “unit of property” for a
wind farm is a single electricity-generating wind turbine, its tower, and its supporting pad. For solar property, if this TAN included solar
installations on different buildings (for example multiple buildings on a college campus or at an apartment complex) or at different locations, each
solar installation is a unit of property.
No
Yes
Explain the replacement or cessation:

Limit to 1,000 characters

4.2. Have there been any interruptions in production during the year, other than routine maintenance?
No
Yes
Provide dates and explanation:

Limit to 1,000 characters

4.3. Attach supporting documentation that provides evidence of annual production — Examples of supporting documentation are: a statement of the
annual metered net electric energy generated during the year by the specified energy property, operation logs showing energy production, utility bills verifying energy
production, a comparison with previous year’s electric bills.
Attached is supporting documentation that provides evidence of annual production:
Browse...
ACCEPTED FILE TYPES: Office (doc, docx, xls, xlsx), comma separated value (csv), Adobe Portable Document Format (pdf), and plain text (txt) formats. Limit total
size of all files to 100 MB or less.
If you require more uploads than this form provides, supplement these with the "Add/Modify Supporting Documentation" function under the
Application Package Control Panel for this application when finished.

Section 5 - Certification and Signature of Owner/Preparer

I certify, under penalties of perjury, that the information provided in the Annual Performance Report to the best of my knowledge and belief is true, correct, and
complete. Further, I agree the information contained in this report can be disclosed to the Internal Revenue Service.
First Name:

Last Name:

Title:

Phone:

Email:

Signature (enter your
password):

000 000
0000 [()-.]

Entering your password has the same legal effect as your handwritten signature.

NOTE: We strongly suggest that you print this form prior to submitting
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The National Renewable Energy Laboratory is providing technical assistance for Section 1603 applications on behalf of the U.S. Treasury Department

Content Last Updated: April 22, 2013 September 30, 2016
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