Schedule A (Form 8 Disposal or Enhanced Oil Recovery Owner Certification

Version A, Cycle 3

Schedule A
(Form 8933)
(December 2024)
Department of the Treasury
Internal Revenue Service

Disposal or Enhanced Oil Recovery Owner Certification
OMB No. 1545-2132

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

Identifying number

Name(s) shown on return

A

Check if you are filing this as a:
(i)
Geological disposal site owner

Part I
1

Name

2

Address

Part II

(ii)

Enhanced oil recovery project owner

Information About You, the Owner of the Geological Disposal Site, or the Enhanced Oil Recovery (EOR)
Project
3

Employer identification number (EIN)

Information About Your Suppliers of Qualified Carbon Oxide

Complete a separate Schedule A (Form 8933) for each of your suppliers of qualified carbon oxide.
4
Name
5 EIN
6

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

7

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

8

9

10

11

INTERNAL USE ONLY
DRAFT AS OF
August 15, 2024

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 the EIN of the entity that’s an owner of the geological disposal site. If the EINs aren’t the same, there must be a
binding written contract between the entities . . . . . . . . . . . . . . . . . . . . . . . . . .
Unless line 8 is checked, do you attest that a binding written contract between you and the supplier exists
that ensures that you will securely store the qualified carbon oxide in the manner required under section
45Q and the underlying regulations? . . . . . . . . . . . . . . . . . . . . . . . .

11

Metric tons of qualified carbon oxide received from the supplier and stored by you during the
calendar year (metric tons should agree with the figure reported for you for this supplier by the
disposal site’s operator on Schedule B (Form 8933), Part III, line 10; or Schedule C (Form 8933),
Part III, line 20) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12

13

Metric tons of nonqualified carbon oxide received by you during the calendar year

.

13

14

Metric tons of nonqualified carbon oxide stored or utilized as a tertiary injectant stored by you
during the calendar year (metric tons should be from Schedule B (Form 8933), Part III, line 10; or
Schedule C (Form 8933), Part III, line 20) . . . . . . . . . . . . . . . . . . .

14

Add lines 11 and 13. Total amount of qualified carbon oxide injected (amount should agree with
the figure reported for you on Schedule B (Form 8933), Part III, line 10; or Schedule C (Form 8933),
Part III, line 20) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15

Add lines 12 and 14. Total amount of qualified carbon oxide stored (amount should agree with the
figure reported for you on Schedule B (Form 8933), Part III, line 10; or Schedule C (Form 8933),
Part III, line 20) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16

15

16

17

No

Provide the date (MM/DD/YYYY) of the contract referenced on line 9 or the date of the most recent
amendment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Metric tons of qualified carbon oxide received from the supplier during the calendar year (metric
tons should agree with the figure reported for you for this supplier by the project’s operator on
Schedule B (Form 8933), Part III, line 10; or Schedule C (Form 8933), Part III, line 20) . . . . .

12

Yes

.

.

.

.

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. If you checked the box, attach Schedule E (Form 8933)

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

Cat. No. 94872G

Schedule A (Form 8933) (12-2024)