5900-545 HFC Request for Additional Consumption Allowances Report

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Overview

Export Information
Export Summary
Blend List

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Sheet 1: Export Information

	U.S. Environmental Protection Agency (EPA)							OMB Control Number: 2060-0734
								Expiration Date: MM/DD/YYYY
	American Innovation and Manufacturing (AIM) Act
	Hydrofluorocarbon (HFC) Request for Additional Consumption Allowances Report
	Worksheet Instructions:
	Complete and submit an HFC Request for Additional Consumption Allowances Report if your company is requesting additional consumption allowances following the export of HFCs. Additional consumption allowances may only be requested for exports that have occurred during the current calendar year. All refunded allowances must also be expended in the same calendar year. Section 1 and Section 2 of the report must be completed prior to submission. Section 3 is automatically populated based on data entered in Section 2.
	Version:
	r0.7
	Updated:
	7/2/2025
	External Links:
	HFC Allocation Rule Reporting HelpDesk	AIM Act Paperwork Reduction Act Burden
	Reporting Form Navigation:
	Section 1 - Company Identification	Section 3 - Export Information
	Section 2 - Allowance Recipient Identification
	EPA may request additional information or ask follow up questions to verify the accuracy of this submission and supporting documentation, including pursuant to Clean Air Act section 114 as authorized under the AIM Act.
	Section 1 - Company Identification
	Instructions: Complete the following company information.
	Company Name:
	Company ID:
	Reporting Year:
	Employer Identification Number (EIN):
	Should the information provided in columns 18-22 (a and b only) in the table below (i.e., source of the regulated substance) be treated as confidential business information (CBI)?
	Section 2 - Allowance Recipient Identification
	Instructions: Identify the person to whom the consumption allowances will be granted, whether the producer, the importer, or the exporter. §84.17(b)(1)(ii)
	Allowance Recipient Company Name:
	Allowance Recipient Company ID:
	Section 3 - Export Information
	Instructions: Enter data for each HFC export transaction for which you are requesting additional consumption allowances. For each transaction, provide a copy of the bill of lading and the invoice indicating the net quantity (in kilograms) of HFC shipped and documenting the sale of the HFC to the purchaser. In addition, provide a copy of the Electronic Export Information (EEI) document, for each Internal Transaction Number (ITN) reported. §84.17(a)(1)(viii)
	HFC Export Information
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	Transaction Number	Date of Export §84.17(a)(6)	Shipment Reference Number	Internal Transaction Number (ITN) §84.17(a)(10)	Port of Exit §84.17(a)(6)	HTS Code §84.17(a)(9)	Country to which the HFCs were Exported §84.17(a)(7)	HFC or HFC Blend Exported §84.17(a)(4)	Quantity of HFC or HFC Blend Exported (kg) §84.17(a)(4)	Blend Information										Recipient Company §84.17(a)(1)	Recipient Company Address §84.17(a)(1)	Recipient Company City §84.17(a)(1)	Recipient Company Country §84.17(a)(1)	Recipient Company Contact Name §84.17(a)(3)	Recipient Company Contact Telephone Number §84.17(a)(3)	Recipient Company Contact Email §84.17(a)(3)	Source Information §84.17(a)(5)
										HFC Exported (1)	HFC Composition of Blend (1) (%)	HFC Exported (2)	HFC Composition of Blend (2) (%)	HFC Exported (3)	HFC Composition of Blend (3) (%)	HFC Exported (4)	HFC Composition of Blend (4) (%)	HFC Exported (5)	HFC Composition of Blend (5) (%)								HFC or HFC Blend Component (1)			HFC or HFC Blend Component (2)			HFC or HFC Blend Component (3)			HFC or HFC Blend Component (4)			HFC or HFC Blend Component (5)
																											Company that Produced or Imported HFC	Source Country, If Imported	Purchased Before January 1, 2022	Company that Produced or Imported HFC	Source Country, If Imported	Purchased Before January 1, 2022	Company that Produced or Imported HFC	Source Country, If Imported	Purchased Before January 1, 2022	Company that Produced or Imported HFC	Source Country, If Imported	Purchased Before January 1, 2022	Company that Produced or Imported HFC	Source Country, If Imported	Purchased Before January 1, 2022
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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 84.17). 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 6 hours per response. Send comments on the Agency’s need this formation, 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, Information Engagement 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 # 5900-545

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Sheet 2: Export Summary

	U.S. Environmental Protection Agency (EPA)				OMB Control Number: 2060-0734
					Expiration Date: MM/DD/YYYY
	American Innovation and Manufacturing (AIM) Act
	Hydrofluorocarbon (HFC) Request for Additional Consumption Allowances Report
	Worksheet Instructions:
	Complete and submit an HFC Request for Additional Consumption Allowances Report if your company is requesting additional consumption allowances following the export of HFCs. Additional consumption allowances may only be requested for exports that have occurred during the current calendar year. All refunded allowances must also be expended in the same calendar year. Section 1 and Section 2 of the report must be completed prior to submission. Section 3 is automatically populated based on data entered in Section 2.
	Version:
	r0.7
	Updated:
	7/2/2025
	External Links:
	HFC Allocation Rule Reporting HelpDesk	AIM Act Paperwork Reduction Act Burden
	Reporting Form Navigation:
	Section 1 - Company Identification	Section 3 - Export Information
	Section 2 - Allowance Recipient Identification
	Section 4 - Summary of Additional Consumption Allowances Requested
	Instructions: The values in the table below are calculated based on data entered in Section 2. If the totals appear to be incorrect, please return to Section 2 to review your data.
	Additional Consumption Allowances Requested
	1	2	3
	HFC Exported §84.17(a)(1)(iv)	Total Quantity Exported (kg)	Amount of Allowances (MTEVe)
1	HFC-23	0.00	0.0
2	HFC-32	0.00	0.0
3	HFC-41	0.00	0.0
4	HFC-43-10mee	0.00	0.0
5	HFC-125	0.00	0.0
6	HFC-134	0.00	0.0
7	HFC-134a	0.00	0.0
8	HFC-143	0.00	0.0
9	HFC-143a	0.00	0.0
10	HFC-152	0.00	0.0
11	HFC-152a	0.00	0.0
12	HFC-227ea	0.00	0.0
13	HFC-236cb	0.00	0.0
14	HFC-236ea	0.00	0.0
15	HFC-236fa	0.00	0.0
16	HFC-245ca	0.00	0.0
17	HFC-245fa	0.00	0.0
18	HFC-365mfc	0.00	0.0

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Sheet 3: Blend List

HFC Blends	HFC-23	HFC-32	HFC-125	HFC-134a	HFC-143a	HFC-152a	HFC-227ea	HFC-236fa
R-401A						0.13
R-401B						0.11
R-401C						0.15
R-402A			0.6
R-402B			0.38
R-404A			0.44	0.04	0.52
R-405A						0.07
R-407A		0.2	0.4	0.4
R-407B		0.1	0.7	0.2
R-407C		0.23	0.25	0.52
R-407D		0.15	0.15	0.7
R-407E		0.25	0.15	0.6
R-407F		0.3	0.3	0.4
R-407G		0.025	0.025	0.95
R-407H		0.325	0.15	0.525
R-407I		0.195	0.085	0.72
R-408A			0.07		0.46
R-410A		0.5	0.5
R-410B		0.45	0.55
R-411A						0.11
R-411B						0.03
R-413A				0.88
R-415A						0.18
R-415B						0.75
R-416A				0.59
R-417A			0.466	0.5
R-417B			0.79	0.183
R-417C			0.195	0.788
R-418A						0.025
R-419A			0.77	0.19
R-419B			0.485	0.48
R-420A				0.88
R-421A			0.58	0.42
R-421B			0.85	0.15
R-422A			0.851	0.115
R-422B			0.55	0.42
R-422C			0.82	0.15
R-422D			0.651	0.315
R-422E			0.58	0.393
R-423A				0.525			0.475
R-424A			0.505	0.47
R-425A		0.185		0.695			0.12
R-426A			0.051	0.93
R-427A		0.15	0.25	0.5	0.1
R-427C		0.25	0.25	0.4	0.1
R-428A			0.775		0.2
R-429A						0.1
R-430A						0.76
R-431A						0.29
R-434A			0.632	0.16	0.18
R-435A						0.2
R-437A			0.195	0.785
R-438A		0.085	0.45	0.442
R-439A		0.5	0.47
R-440A				0.016		0.978
R-442A		0.31	0.31	0.3		0.03	0.05
R-444A		0.12				0.05
R-444B		0.415				0.1
R-445A				0.09
R-446A		0.68
R-447A		0.68	0.035
R-447B		0.68	0.08
R-448A		0.26	0.26	0.21
R-448B		0.21	0.21	0.31
R-449A		0.243	0.247	0.257
R-449B		0.252	0.243	0.273
R-449C		0.2	0.2	0.29
R-450A				0.42
R-451A				0.102
R-451B				0.112
R-452A		0.11	0.59
R-452B		0.67	0.07
R-452C		0.125	0.61
R-453A		0.2	0.2	0.538			0.05
R-454A		0.35
R-454B		0.689
R-454C		0.215
R-455A		0.215
R-456A		0.06		0.45
R-457A		0.18				0.12
R-457B		0.35				0.1
R-458A		0.205	0.04	0.614			0.135	0.006
R-459A		0.68
R-459B		0.21
R-460A		0.12	0.52	0.14
R-460B		0.28	0.25	0.2
R-460C		0.025	0.025	0.46
R-461A			0.55	0.32	0.05		0.05
R-462A		0.09	0.42	0.44	0.02
R-463A		0.36	0.3	0.14
R-464A		0.27	0.27				0.06
R-465A		0.21
R-466A		0.49	0.115
R-467A		0.22	0.05	0.724
R-468A		0.215
R-469A		0.325	0.325
R-470A		0.17	0.19	0.07			0.03
R-470B		0.115	0.115	0.03			0.07
R-471A							0.043
R-472A		0.12		0.19
R-473A	0.1		0.1
R-500						0.262
R-503	0.401
R-504		0.482
R-507			0.5		0.5
R-507A			0.5		0.5
R-508A	0.39
R-508B	0.46
R-512A				0.05		0.95
R-513A				0.44
R-513B				0.415
R-515A							0.12
R-515B							0.089
R-516A				0.085		0.14