Repowering Assistance Program - Individuals

Instructions for RD Form 4288-06

Repowering Assistance Program � Reporting Form

This form must be submitted to the appropriate office to process payment for Repowering Assistance.

Prepared by the Awardee.� Submit the one original. Original signed by approval official of awardee.

Original should be sent to the appropriate USDA RD Energy Division in Washington DC.

Part A: Project Information

Fld Name / Item No.	Instruction
1. Name of Biorefinery	Enter name.
2. Agreement Number	Enter agreement number.
3.� Mail Address	Enter mailing address.
4. Congressional District	Enter the congressional district.
5. IRS Tax Identification Number	Enter the tax identification number.
6. Contact Person	Enter contact person name.
7. Contact Person Title	Enter contact person title.
8. Telephone No.	Enter contact person telephone number.

Part B: Reporting

Fld Name / Item No.	Instruction
1. Date of completion of the repowering project	Enter the date on which the biorefinery began the use of biomass as a replacement for fossil fuels.
2. Description of the repowering project as completed.	Describe the equipment. installed, including manufacturer�s name, rated capacity, type of energy produced and amount of energy expected to be produced by the project. �
3. Describe the metering equipment used to determine the production of usable energy from renewable biomass	Enter the type of device, manufacturer�s name, model number, serial number, type of energy measured and units measure for all equipment used.
4. Actual Total Cost	Enter the total project costs minus any cost associated with the production of energy that will be sold.
5. Amount of Energy Production	Enter amount of energy produce in block 5a through 5g.
6. Amount of each biomass feedstock	Enter the amount of each type of biomass feedstock used in the production of energy.
7. Amount and type of energy produced or purchased by the Biorefinery that is not derived from the repowering project.	Enter the concurrent period meter readings or shipments, serial number bin/tank location, meter reading at the end and begin period and unit consumption.

Part C: Certification

Fld Name / Item No.	Instruction
1a. Biorefinery Name	Enter biorefinery name.
1b. Date	Enter date.
1c. Title	Enter the person who will sign document title.