Form 8933 Schedule Utilization Certification

Schedule F
(Form 8933)

Utilization 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

Information About the Qualified Carbon Utilization Facility and Utilization of Carbon Oxide

Section 1—Information about owner or lessee(s) of the carbon utilization facility and utilization of qualified carbon oxide at this facility
1
Provide information about each owner or lessee of the carbon oxide utilization facility during the calendar year.
• If there are more than four owners or lessees, prepare a separate schedule with all the owner or lessee 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.
(i) Name

A
B
C
D
2
3

(ii) Owner/
Lessee

(iii) Address

(iv) Employer
identification
number (EIN)

(v) Operating
interest (%)

Name of the utilization facility
Location of the utilization facility (street, county, and state)

4

Registered owner or operator

5

Provide information about utilization of qualified carbon oxide at this facility below.
Check all that apply.
a

Fixation through photosynthesis or chemosynthesis, such as
through the growing of algae or bacteria.

b

Chemical conversion to a material or chemical compound in
which qualified carbon oxide is securely stored.

c

For any other purpose for which a commercial market exists
(with the exception of use as a tertiary injectant in a qualified
enhanced oil or natural gas recovery project), as determined
by regulations or other official guidance.

Describe in more detail how the qualified carbon oxide is utilized.

.

Yes

No

(2) Have you attached a statement substantiating that a commercial market exists? Don’t complete this schedule unless you answered “Yes” to the
questions on lines 5c(1) and 5c(2). See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

No

(1) Do you attest that a commercial market exists for your particular product, process, or service?

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

.

.

.

.

Cat. No. 94877J

.

.

.

.

.

.

.

.

.

.

.

.

.

Schedule F (Form 8933) (12-2024)

Page 2

Schedule F (Form 8933) (12-2024)

Part I

Information About the Qualified Carbon Utilization Facility and Utilization of Carbon Oxide (continued)

Section 2—Information about the qualified carbon oxide supplied to the utilization facility
6

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. “Supplier” means the person who captured the qualified carbon oxide, which may differ from the company
that sold the carbon oxide or physically delivered the carbon oxide to the owner of the utilization facility. If there are more than three suppliers of qualified carbon oxide to
the utilization facility, prepare a separate table with all the information and attach it to this schedule.
(i) Qualified carbon
oxide supplier

A
B
C
7
8

(ii) EIN

(iii) Name of
capture facility

(v) IRS-issued registration
number

(vi) EPA
e-GGRT
ID number(s)

(vii) Check if
supplier
supplied any
nonqualified
carbon oxide

List all suppliers of nonqualified carbon oxide
Provide utilization information that conforms to the Life Cycle Assessment (LCA) that was approved by the Department of Energy (DOE) and the IRS. If there are more than
four owners of the utilization facility or three suppliers of qualified carbon oxide, prepare a separate table with all the information and attach it to this schedule.
Qualified Carbon Oxide Supplier
(a) Owner or lessee
of utilization facility

(i)
(b) Metric tons of
qualified carbon oxide
delivered to
utilization facility

A
B
C
D
Total

(iv) Location of
capture facility
(county and state)

.

.

.

.

.

.

.

.

.

(c) Metric tons of
qualified carbon oxide
utilized

(iii)

(d) Metric tons of
qualified carbon oxide
delivered to
utilization facility

(e) Metric tons of
qualified carbon oxide
utilized

(f) Metric tons of
qualified carbon oxide
delivered to
utilization facility

(g) Metric tons of
qualified carbon oxide
utilized

.

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

(ii)

(i) Metric tons of
carbon oxide utilized
(add columns (c), (e), and (g))

(v) Total nonqualified carbon oxide
from all suppliers
(j) Metric tons of carbon oxide
delivered to utilization facility

(k) Metric tons of
carbon oxide utilized

(vi) Total metric tons
for all carbon oxide suppliers
(l) Metric tons of carbon oxide
delivered to utilization facility
(add columns (h) and (j))

(m) Metric tons of
carbon oxide utilized
(add columns (i) and (k))

A
B
C
D
Total
9
Check here to attest that all information provided on line 8 conforms to the LCA that was subject to a technical review by the DOE, and approved by the IRS . . .
10
Attach a copy of the LCA approval letter from the IRS. Don’t file this schedule if you haven’t received the approval letter.
If the total for column (h) is less than 25,000 metric tons, have you verified with the supplier that its facility meets the minimum capture requirements?
Yes
11

.
No

Schedule F (Form 8933) (12-2024)

Page 3

Schedule F (Form 8933) (12-2024)

Part II

Information About the LCA and This Claim

1

Title of the LCA submitted to the DOE

3

Project or LCA number assigned by the DOE

5
6

Attach a copy of the approval letter from the IRS.
State if you’re applying the Treasury Decision 9944 (TD) or the June 2020 Notice of Proposed Rulemaking (NPRM)

Part III

2
4

Date (MM/DD/YYYY) the LCA was submitted to the DOE

Date (MM/DD/YYYY) approval letter for the utilization facility was received from the IRS

Information About You and Each of Your Suppliers of Qualified Carbon Oxide

Section 1—Information about you, the owner or lessee of the utilization project
1
Name
2

3

EIN

Address

Section 2—Information about all suppliers of qualified carbon oxide to you. Complete multiple schedules if you had more than one supplier of qualified carbon oxide.
4
Supplier’s name
5 Supplier’s EIN
6

Name and location of carbon oxide capture facility (if supplier supplied any
qualified carbon oxide)

7

8

Check here if you were one of the suppliers. Don’t check unless the EIN of the supplier of the qualified carbon oxide is the same as your EIN. If the EINs aren’t the
same, there must be a binding written contract between the entities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9

Unless line 8 is checked, do you attest that a binding written contract between you and the supplier exists that ensures that you will utilize its qualified
carbon oxide in the manner required under section 45Q(f)(5) and the underlying regulations? . . . . . . . . . . . . . . . . . . . .

Type of industrial facility at which the supplier captured its qualified carbon oxide

10

Provide the date (MM/DD/YYYY) of the contract referenced on line 9 or the date of the most recent contract amendment .

11

Metric tons of qualified carbon oxide received from the supplier during the year and used in the process indicated on line 6 (metric tons
should agree with the figure reported on Part I, line 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11

Metric tons of the supplier’s qualified carbon oxide, expressed as carbon dioxide equivalent, utilized in your facility and determined by an
LCA (metric tons should agree with the figure reported on Part I, line 8) . . . . . . . . . . . . . . . . . . . . . . .

12

Metric tons of the supplier’s nonqualified carbon oxide, expressed as carbon dioxide equivalent, utilized in your facility and determined by an
LCA (metric tons should be part of the figure on Part I, line 8) . . . . . . . . . . . . . . . . . . . . . . . . . . .

13

12

13

14

.

.

.

.

.

.

.

Yes

No

.

Check here if you attest that the supplier of qualified carbon oxide elected to allow you to claim some or all of the carbon oxide sequestration credit attributable to their
qualified carbon oxide. Attach Schedule E (Form 8933) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 8933) (12-2024)