5900-551 HFC Application-Specific Allowance Holder Biannual

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Overview

Company Information
Next Year Allowances

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Sheet 1: Company Information

OMB Control Number: 2060-0734

Expiration Date: XX/XX/202X

American Innovation and Manufacturing Act - HFC Application-Specific Allowance Holder Biannual Report

Worksheet Instructions:

Complete and submit an HFC Application-Specific Allowance Holder Biannual Report if your company was allocated application-specific allowances (excluding recipients of application-specific allowances for mission-critical military end uses). Sections 1 and 2 must be completed prior to submission. Section 3 must be completed if allowances were conferred and/or material was received during the reporting period. Sections 4-9 should only be completed when submitting data for the January 1 – June 30 reporting period. Section 5 is required if your company is requesting additional allowances due to one or more of the circumstances listed in 84.13(b)(1). Section 6 is required if your company contracts out the manufacturing of defense sprays or metered dose inhalers, or pays another person to perform the servicing of onboard aerospace fire suppression. Sections 7-8 are required if you are requesting application-specific allowance for the first time. Section 9 is optional.

Version:

r0.6

Updated:

X/X/2023

External Links:

HFC Allocation Rule Reporting HelpDesk

AIM Act Paperwork Reduction Act Burden

Reporting Form Navigation:

Section 1 - Company Identification

Section 6 - Contracting Information

Section 2 - Application-Specific Data

Section 7 - Quantity Acquired in Previous Three Years

Section 3 - Allowance Conferral Data

Section 8 - Application Information

Section 4 - Transition Plan

Section 9 - Total Quantity Requested for the Next Calendar Year (Optional)

Section 5 - Unique Circumstances

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.

Company Name:

Company ID:

Reporting Year:

Reporting Period:

Were allowances conferred or were HFCs received from a company to which allowances were conferred during the reporting period?

Is your company requesting additional allowances due to one or more of the circumstances listed in §84.13(b)(1)?

Does the company contract out the manufacturing of defense sprays or metered dose inhalers, or pay another person to perform the servicing of onboard aerospace fire suppression?

Is your company requesting application-specific allowances for the first time?

Section 2 - Application-Specific Data

Instructions: Enter the quantity of each regulated substance that was acquired through conferring allowances, directly imported, or purchased without expending application-specific allowances (i.e., from the open market) during the previous six months. Additionally, provide the quantity held in inventory on the last day of the previous six-month period, and the quantity destroyed or recycled during the previous six months. Provide a screenshot from your tracking system, invoices, or other records documenting the quantity of material acquired held in inventory, if applicable.

HFC Application-Specific Data

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HFC

Quantity Acquired through Conferring Allowances (kg) §84.31(h)(1)(i)

Quantity of HFCs Your Company Imported Expending Your Allowances (kg) §84.31(h)(1)(ii)

Quantity of HFCs Purchased for Application-Specific Use without Expending or Conferring Your Allowances (kg) §84.31(h)(1)(iii)

Quantity Held in Inventory by the Reporting Company or Held under Contract by Another Company for the Reporting Company’s Use (kg) §84.31(h)(1)(iv)

Quantity Destroyed (kg) §84.31(h)(1)(v)

Quantity Recycled (kg) §84.31(h)(1)(v)

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Section 3 - Allowance Conferral Data

Instructions: Provide the names of the companies to which application-specific allowances were conferred during the reporting year as well as the quantity of regulated substances received from each company during the past six months.

HFC Allowance Conferral Data §84.31(h)(1)(vi)

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6a

6b

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7b

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9b

Company to Which Allowances Were Conferred

Company Contact Name

Company Contact Email

Company Contact Phone

Quantity of Allowances Conferred (MTEVe)

HFC (1) Received

Quantity of HFC (1) Received (kg)

HFC (2) Received

Quantity of HFC (2) Received (kg)

HFC (3) Received

Quantity of HFC (3) Received (kg)

HFC (4) Received

Quantity of HFC (4) Received (kg)

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This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0734). Responses to this collection of information are mandatory (40 CFR 84.31). 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 12 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 # 5900-551

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Sheet 2: Next Year Allowances

OMB Control Number: 2060-0734

Expiration Date: XX/XX/202X

American Innovation and Manufacturing Act - HFC Application-Specific Allowance Holder Biannual Report

Worksheet Instructions:

Complete and submit an HFC Application-Specific Allowance Holder Biannual Report if your company was allocated application-specific allowances (excluding recipients of application-specific allowances for mission-critical military end uses). Sections 1 and 2 must be completed prior to submission. Section 3 must be completed if allowances were conferred and/or material was received during the reporting period. Sections 4-7 should only be completed when submitting data for the January 1 – June 30 reporting period. Section 5 is required if your company is requesting additional allowances due to one or more of the circumstances listed in 84.13(b)(1). Section 6 is required if your company contracts out the manufacturing of defense sprays or metered dose inhalers, or pays another person to perform the servicing of onboard aerospace fire suppression. Section 7 is required when completing your July 2022 report or if you are requesting application-specific allowance for the first time.

Version:

r0.6

Updated:

X/X/2023

External Links:

HFC Allocation Rule Reporting HelpDesk

AIM Act Paperwork Reduction Act Burden

Reporting Form Navigation:

Section 1 - Company Identification

Section 6 - Contracting Information

Section 2 - Application-Specific Data

Section 7 - Quantity Acquired in Previous Three Years

Section 3 - Allowance Conferral Data

Section 8 - Application Information

Section 4 - Transition Plan

Section 9 - Total Quantity Requested for the Next Calendar Year (Optional)

Section 5 - Unique Circumstances

Section 4 - Transition Plan

Instructions: Provide a description of plans to transition application-specific use of regulated substances to regulated substances with a lower exchange value or alternatives to regulated substances. §84.31(h)(1)(vii)

Section 5 - Unique Circumstances

Instructions: If the company is requesting allowances in addition to what the Agency will calculate based on data provided in Section 2 and Section 7, specify the unique circumstances under which you are requesting those additional allowances. §84.13(b)(1)

Demonstrated manufacturing capacity coming on line:

The acquisition of another domestic manufacturer or its manufacturing facility or facilities:

A global pandemic or other public health emergency that increases patients diagnosed with medical conditions treated by metered dose inhalers:

Provide a projection of the monthly quantity of additional regulated substances needed for application-specific uses due to the unique circumstance(s) specified above by month in the next calendar year.

Additional Quantity Needed for Application-Specific Use Due to Unique Circumstances §84.31(h)(1)(viii)

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HFC

January (kg)

February (kg)

March (kg)

April (kg)

May (kg)

June (kg)

July (kg)

August (kg)

September (kg)

October (kg)

November (kg)

December (kg)

Total (kg)

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Provide a detailed explanation to justify the additional need for each applicable unique circumstance. §84.31(h)(1)(viii)

Have you provided documentation along with this report that supports this additional need due to your unique circumstance(s)? Supporting documentation includes information in a format that can be verified, such as copies of permits or other documentation to clarify when the new line or facility is opening, agency approvals for new products or product modifications, and more recent sales numbers to document growth in MDI sales resulting from a public health emergency.

Section 6 - Contracting Information

Instructions: If the company is contracting out the manufacturing of defense sprays or metered dose inhalers, or paying another person (whether it is in cash, credit, goods, or services) to perform the servicing of onboard aerospace fire suppression, complete the following information for the contact doing to manufacturing or servicing.

Manufacturing/Servicing Representative §84.31(h)(1)(ix)

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Company Name

Contact Name

Contact Email

Contact Street Address

Contact City

Contact State

Contact Zip

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Provide clarification on whether the responses in this report apply to the company that is allocated application-specific allowances or the company receiving the contract for manufacturing and/or servicing using application-specific allowances. §84.31(h)(1)(ix)

Section 7 - Quantity Acquired in Previous Three Years

Instructions: For persons requesting application-specific allowances for the first time, provide the total quantity of all regulated substances acquired for application-specific use in the previous three years. Provide a copy of the sales records, invoices, or other records documenting that quantity. Make sure to specify the HFC weight per cylinder or unit if not included in the sales records or invoices. §84.31(h)(2)(ii)

Year

Reporting Period

July 1 - December 31

January 1 - June 30

July 1 - December 31

January 1 - June 30

July 1 - December 31

January 1 - June 30

HFC

Quantity Acquired (kg)

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Section 8 - Application Information

Instructions: If you are requesting application-specific allowances for the first time, please provide a description of the use of regulated substances and a detailed explanation of how the use is an application-specific use listed in §84.13(a). §84.31(h)(2)(i)

Application

Description

Section 9 - Total Quantity Requested for the Next Calendar Year (Optional)

Instructions: Provide an estimate of the total quantity of allowances you are requesting for the next calendar year. Note that EPA will allocate to the requested level if we can verify you are eligible for that amount.

Total Quantity Requested for the Next Calendar Year

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HFC

Quantity Requested (kg)

Quantity Requested (MTEVe)

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Total

0.00