Form EIA-856 Monthly Foreign Crude Oil Acquisition Report

FORM EIA-856
MONTHLY FOREIGN CRUDE OIL ACQUISITION REPORT

OMB No. 1905-0174
Expiration Date: XX/XX/XXXX
Burden: 6.1 hours

This report is mandatory under the Federal Energy Administration Act of 1974 (Public Law 93-275). Failure to comply may result in criminal
fines, civil penalties and other sanctions as provided by law. Title 18 USC 1001 makes it a criminal offense for any person knowingly and
willingly to make to any Agency or Department of the United States any false, fictitious, or fraudulent statements as to any matter
within its jurisdiction. See Instructions for further details on the sanctions and the provisions concerning the confidentiality of information
submitted on this form.

PART 1. RESPONDENT IDENTIFICATION
If any Respondent Identification information has changed
since the last report, enter an "X" in the block:
Mo
Year
Report Period:
EIA ID NUMBER:

Due Date: A completed form must be filed by
the 30th calendar day following the end of the
report month.
Instructions:
http://www.eia.gov/survey/form/eia_856/instructions.pdf

Company Name:

Appendix A:

Physical Address:
(e.g., Street Address, Bldg, Floor, Suite)
Mailing Address:
(e.g., PO Box, RR)
City:
State:
Contact Name:

Zip Code

Phone No.:

-

Email address:
Date of this Report:
Type of Report (Check One ):
(1)
Original
(2)
Resubmission
Revision to Report:
PART 2. SUMMARY DATA
1. Total Acquisitions

http://www.eia.gov/survey/form/eia_856/eia856appa.pdf

Appendix B:
http://www.eia.gov/survey/form/eia_856/eia856appb.pdf

Form must be submitted using the following method:

Secure File Transfer:

-

https://signon.eia.doe.gov/upload/noticeoog.jsp

Ext:

Mo

Day

Year

Questions?

Please contact the EIA Survey Support Team
using the following communication methods:
Email: eia4usa@eia.gov
Phone: 1-855-EIA-4USA (1-855-342-4872)

Mo

Day

Year

(Enter the total volume of foreign crude oil acquired during the report
month for importation into the United States. This is the sum of
column (l), Part III, excluding resubmission.)

Monday through Friday, 8:00 A.M. to 6:00 P.M. ET

Barrels

2. Offshore Inventories
(Enter the total volume of foreign oil owned by the firm, for eventual
importation into the United States which is held in storage outside
the United States and/or is enroute to the United States as of the
end of the report month.)

Barrels

OMB Number: 1905-0174
Expiration Date: XX/XX/XXXX
Burden: 6.1 hours

FORM EIA-856
MONTHLY FOREIGN CRUDE OIL ACQUISITION REPORT
PART 3. TRANSACTIONS

(a)
(b)
(c)
Transaction Type of Country/
Num- Trans- Crude Code
ber action

Page

of

EIA ID NUMBER:

(d)

(e)

(f)

(g)

Crude Type

Gravity

Date of
Loading
(YYMMDD)

Port
of
Loading

(h)
(I)
Port Date of
of
Landing
Desti- (YYMM)
nation

Comments: (Report any occurences that could explain variation in the data reported)

(j)
Vessel/Carrier

(k)
Contract/Point
Code

(l)
Volume
Acquired
(BBLs)

Report Period:
Date submitted:
(m)
(n)
(o)
(p)
Acquisi- Other Landed
tion Price Cost
Cost
Days
($/BBLs) ($/BBL) ($/BBL) Credit

Mo

Year
(q)
Name of Vendor