STEP 1

Enter the compliance

year and ATS account number.

STEP 2

Check the appropriate

box.

STEP 3

Enter the serial numbers of the allowances to be

deducted.

You may specify single

allowances or a series

of allowances. In the

total column, enter the

total number of allowances to be deducted. Enter separate series or series with a different use date on a separate line.

STEP 4

Read the certification

statement, and sign and date.

United States

Environmental Protection Agency	OMB No. 2060-0258

Acid Rain Program

Allowance Deduction (Optional)

For more information, see instructions and refer to 40 CFR 72.90

Compliance Year

ATS Account Number

Facility Name

This deduction is for: __ Annual Compliance __ Excess Emissions Offset Plan

Immediate Deduction

Allowance Year	Start Number	End Number	Total
-	-
-	-
-	-
-	-
-	-
-	-
-	-
-	-
-	-
-	-
-	-
-	-
-	-
-	-
-	-
-	-
-	-

Certification

I am authorized to make this submission on behalf of the owners and operators of the affected source or affected units for which the submission is made. I certify under penalty of law that I have personally examined, and am familiar with, the statements and information submitted in this document and all its attachments. Based on my inquiry of those individuals with primary responsibility for obtaining the information, I certify that the statements and information are to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant penalties for submitting false statements and information or omitting required statements and information, including the possibility of fine or imprisonment.

Signature

Date
Page __ of __

Step 1	Enter the Compliance Year, the Allowance Tracking System (ATS) Account Number of the facility (i.e., plant) from which allowances are to be deducted, and the Facility Name.

Step 2	Mark the appropriate box to indicate the type of deduction for which this form is being submitted. Mark only one box. You must submit a separate form for each type of deduction.

Step 3	List by serial number the allowances to be deducted. You may specify single allowances or a series of allowances. In the total column, enter the total number of allowances to be deducted.

Verify the accuracy of your entries by computing one of the following simple equations:

Start Number = End Number - Total + 1

or

End Number = Start Number + Total - 1

NOTE: If the serial number range does not correspond with the figure for the total number of allowances, then EPA will rely on the serial number range and not the total number.

You may copy the form to list additional allowances to be deducted. When you have completed the form, for each ATS account number indicate the page order and total number of pages (e.g., 1 of 4, 2 of 4, etc.) in the boxes in the lower left hand corner of each page.

Except for Excess Emissions Offset Plan Immediate Deductions, the compliance use date in the first four digits of the serial numbers of allowances to be deducted must be the same as, or a year prior to, the compliance year listed in Step 1. Allowances identified for Excess Emissions Offset Plan Immediate Deduction must have a compliance use date that is for the year immediately following the compliance year.

If you do not identify enough allowances by serial number, EPA will deduct any additional allowances necessary on a first-in, first-out (FIFO) basis starting with those allowances with the earliest date of recordation into the compliance account (generally, allowances originally allocated by EPA to the unit will have the earliest date of recordation).

If you identify more than enough allowances, EPA will deduct the allowances in the order listed on the form. EPA will not deduct more allowances than necessary for compliance.

Step 4	Read the Certifications, sign, and date.

Mailing Instructions	Mail this form to EPA at one of the following addresses:

for regular or certified mail:	for overnight mail:

U.S. EPA	U.S. EPA

Acid Rain Program (6204J)	Acid Rain Program (6204J)

Attention: Annual Reconciliation	Attention: Annual Reconciliation

1200 Pennsylvania Avenue, NW	1310 L Street, NW.,

Washington, DC 20460	Second Floor

Washington, DC 20005

Phone: 202-343-9150

Paperwork Burden Estimate

The public reporting and recordkeeping burden for this collection of information is estimated to average 3 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, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 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.