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AH XSL/XML Fileid: … ns/i8933/202312/a/xml/cycle06/source (Init. & Date) _______

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Department of the Treasury
Internal Revenue Service
Instructions for Form 8933

(Rev. December 2023)
Carbon Oxide Sequestration Credit

Section references are to the Internal Revenue Code • Extended the deadline to begin construction of facility
unless otherwise noted. from 2026 to 2033.
• Changed the base rate for section 45Q(b)(1)(A)(i)(I)
Future Developments and (ll) rates to $17 and $12 ($85 and $60 if section
For the latest information about developments related to 45Q(h)(2) requirements are met), respectively, for tax
Form 8933 and its instructions, such as legislation years beginning after 2022.
enacted after they were published, go to IRS.gov/ • Changed the base rate for section 45Q(b)(1)(B)(i) and
Form8933. (ii) rates to $36 and $26 ($180 and $130 if section 45Q(h)
(2) requirements are met), respectively, for direct air
What’s New capture (DAC) facilities, for tax years beginning after 2022.
Credit rates and applicable dollar amounts. The • Reduced annual thresholds of captured carbon oxide
credit rates for Part III, lines 1 through 6, are adjusted for for a qualified electric generating facility, a qualified DAC
inflation and increased, per Notice 2023-46. The facility, and any other facility. See Facility.
applicable dollar amounts for Part III, lines 7 through 9, are • Changed the credit reduction percentage to 15%. See
established by linear interpolation between statutory dollar Coordination With Section 142 Bond Financing.
amounts and increased, per Notice 2018-93. The new • Added definitions for new terms, including Applicable
applicable dollar amounts for Part III, lines 10 through 15, electric generating unit Baseline carbon oxide production, ,
are established by the Inflation Reduction Act of 2022 and Capacity factor.
(IRA22). See 2023 inflation adjusted credit rates and • Allows the section 45Q(f)(9) election for carbon oxide
applicable dollar amounts, later. captured and disposed of after 2021 for a facility located
in a federally declared disaster area. See Section 45Q(f)
Tax-exempt and governmental entities. For tax years (9) Election.
beginning after 2022, applicable entities (such as certain • Made prevailing wage and apprenticeship
tax-exempt and governmental entities) can elect to treat requirements. See Notice 2022-61, 2022-52 I.R.B. 561,
the carbon oxide sequestration credit (the credit) for new available at IRS.gov/irb/2022-52_IRB#NOT-2022-61. See
carbon capture equipment (equipment) as a payment of Increased Credit Amount for Facilities and Equipment to
income tax. See Applicable entities, later. determine your qualification for the increased credit
Electing taxpayers. For tax years beginning after 2022, amounts by meeting certain requirements.
taxpayers, partnerships, and S corporations, electing to be
treated as applicable entities, can elect to treat the credit General Instructions
for facility or equipment placed in service after 2022 as a
payment of income tax. See Taxpayers electing to be Purpose of Form
treated as applicable entities, later. Use Form 8933 to claim the section 45Q carbon oxide
Credit transfers. For tax years beginning after 2022, sequestration credit. See Definitions, later.
eligible taxpayers, partnerships, and S corporations that
For purposes of this form, a partner in a partnership
don’t elect payment can elect to transfer all or part of the
that has made a valid section 761(a) election will be
credit for new or existing equipment installed at a qualified
considered the taxpayer. Partnerships with valid section
facility (facility) otherwise allowed as a general business
761(a) elections aren’t required to complete or file this
credit to an unrelated third-party buyer in exchange for
form. Instead, the partner is required to complete and file
cash. Eligible taxpayers don't include applicable entities
this form in a manner commensurate with its undivided
and electing taxpayers discussed above. See Credit
ownership interest in the facility. Also, see Rev. Proc.
transfers, later.
2020-12, 2020-11, I.R.B. 511, for allocation safe harbor.
Pre-filing registration. The IRS has established a However, if you elect to use the January 2021 Treasury
pre-filing registration process to elect payment or transfer Decision 9944 (TD), the section 761(a) election applies
of the credit. See Pre-filing registration requirement for only in the case of qualified carbon oxide captured using
payments or transfers, later. equipment that's originally placed in service at a facility
Facility information. Form 8933 and its instructions before February 9, 2018. For qualified carbon oxide
separate information and computation of the credit for captured using equipment that's originally placed in
each facility or equipment installed in a facility. See Part II. service at a facility on or after February 9, 2018, for each
Information About Facility, later. single process train of equipment (as described in
Regulations section 1.45Q-2(c)(3)), only one taxpayer will
Reminders be considered the person to whom the credit is
attributable and only that person may claim the credit. See
A summary of major changes to section 45Q is as Regulations section 1.45Q-1(h)(1).
follows.

Jan 25, 2024 Cat. No. 74390F

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  Taxpayers other than partnerships or S corporations             • Line 2b: $13.47 per metric ton.
whose only source of this credit is from those                    • Line 3b: $13.47 per metric ton.
pass-through entities (other than a partnership with a valid      • Line 4b: $26.94 per metric ton.
761(a) election) aren’t required to complete or file this         • Line 5b: $13.47 per metric ton.
form. Instead, report this credit directly on line 1x in Part III • Line 6b: $13.47 per metric ton.
of Form 3800, General Business Credit.                              See Notice 2023-46, 2023-26 I.R.B. 1086, available at 
                                                                  IRS.gov/irb/2023-26_IRB#NOT-2023-46.
How To Figure the Credit
Subject to the section 45Q(f)(3)(B) election (discussed             For any tax year beginning in a calendar year after 2016 
later), section 45Q(a)(1) allows a credit of $20 per metric       and before 2027, the section 45Q(b)(1)(A) (as in effect 
ton of qualified carbon oxide captured by you using               before August 16, 2022) applicable dollar amounts for Part 
equipment that’s (1) originally placed in service at a facility   III, lines 7b, 8b, and 9b, are established by linear 
before February 9, 2018, (2) disposed of by you in secure         interpolation between $22.66 and $50, and $12.83 and 
geological storage, and (3) not used by you as a tertiary         $35, respectively. The applicable dollar amounts are as 
injectant in an enhanced oil recovery (EOR) or natural gas        follows.
recovery project or utilized by you in a manner described         • Line 7b: $40.89 per metric ton.
in section 45Q(f)(5).                                             • Line 8b: $27.61 per metric ton.
                                                                  • Line 9b: $27.61 per metric ton.
  Section 45Q(a)(2) allows a credit of $10 per metric ton           See Notice 2018-93, 2018-51 I.R.B. 1041, available at 
of qualified carbon oxide (1) captured by you using               IRS.gov/irb/2018-51_IRB#NOT-2018-93.
equipment that’s originally placed in service at a facility 
before February 9, 2018; and (2) either (a) used by you as          For any tax year after 2022, the section 45Q(b)(1)(A) 
a tertiary injectant in an EOR or natural gas recovery            applicable dollar amounts are as follows.
project and disposed of by you in secure geological               • Line 10b: $17 per metric ton.
storage, or (b) utilized by you in a manner described in          • Line 11b: $12 per metric ton.
section 45Q(f)(5).                                                • Line 12b: $12 per metric ton.
                                                                    For any tax year after 2022, the section 45Q(b)(1)(B) 
  Section 45Q(a)(3) allows a credit of the applicable             applicable dollar amounts for DAC facilities are as follows.
dollar amount (as determined under section 45Q(b)(1))               Line 13b: $36 per metric ton.
                                                                  •
per metric ton of qualified carbon oxide (1) captured by            Line 14b: $26 per metric ton.
                                                                  •
you using equipment that’s originally placed in service at a        Line 15b: $26 per metric ton.
                                                                  •
facility on or after February 9, 2018, during the 12-year 
period beginning on the date the equipment was originally           Facilities or any equipment installed at a facility and 
placed in service, (2) disposed of by you in secure               placed in service after 2022 that satisfy certain 
geological storage, and (3) neither used as a tertiary            requirements may claim an increased credit amount. See 
injectant in an EOR or natural gas recovery project nor           Increased Credit Amount for Facilities and Equipment and 
utilized in a manner described in section 45Q(f)(5).              the specific instructions for lines 4–6 and lines 10–15, 
                                                                  later.
  Section 45Q(a)(4) allows a credit of the applicable 
dollar amount (as determined under section 45Q(b)(1))             Amount captured by additional carbon capture 
per metric ton of qualified carbon oxide (1) captured by          equipment on existing facility.  For a qualified facility 
you using equipment that’s originally placed in service at a      placed in service before February 9, 2018, for which 
facility on or after February 9, 2018, during the 12-year         additional carbon capture equipment is placed in service 
period beginning on the date the equipment was originally         on or after February 9, 2018, the amount of qualified 
placed in service; and (2) either (a) used by you as a            carbon oxide that’s captured by you is the following.
tertiary injectant in an EOR or natural gas recovery project      • For purposes of lines 1 through 6, equal to the lesser of 
and disposed of by you in secure geological storage, or           (a) the total amount of qualified carbon oxide captured at 
(b) utilized in a manner described in section 45Q(f)(5).          such facility for the tax year, or (b) the total amount of the 
                                                                  carbon dioxide capture capacity of the carbon capture 
  For purposes of determining the credit, you may elect           equipment in service at such facility on the day before 
under section 45Q(b)(3) to have the dollar amounts                February 9, 2018.
applicable under section 45Q(a)(1) or (2) apply in lieu of        • For purposes of lines 7 through 15, an amount (not less 
the dollar amounts applicable under section 45Q(a)(3) or          than zero) equal to the excess of (a) the total amount of 
(4) for each metric ton of qualified carbon oxide that’s          qualified carbon oxide captured at such facility for the tax 
captured by you using equipment that’s originally placed          year, over (b) the total amount of the carbon dioxide 
in service at a facility on or after February 9, 2018.            capture capacity of the carbon capture equipment in 
  For the purpose of calculating the credit, a metric ton of      service at such facility on the day before February 9, 2018.
carbon oxide includes only the contained weight of the            Applicable entities. For tax years beginning after 2022, 
carbon oxide. The weight of any other substances, such            applicable entities as defined under section 6417(d)(1)(A) 
as water or impurities, isn’t included in the calculation.        that generally don't benefit from income tax credits can 
2023 inflation adjusted credit rates and applicable               elect to treat the credit for a facility or equipment installed 
dollar amounts. The credit rates for Part III, lines 1b, 2b,      in a facility and placed in service after 2022 as a payment 
3b, 4b, 5b, and 6b are increased by the adjustment for            of income tax. Resulting overpayments may result in 
inflation. The rates are as follows.                              refunds.
• Line 1b: $26.94 per metric ton.

2                                                                         Instructions for Form 8933 (Rev. 12-2023)

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Applicable entities making the elective payment transfer of credits. See Pub. 5884, Inflation Reduction Act
election for the credit must file the following. (IRA) and CHIPS Act of 2022 (CHIPS) Pre-Filing
• Form 8933, with all required statements. Registration Tool. Also see Registering for and Making
• Form 3800, General Business Credit. Elective Payment and Transfer Elections in the
• Form 990-T, Exempt Organization Business Income Tax Instructions for Form 3800.
Return, or other applicable income tax return.
Definitions
For a discussion of who is considered an applicable
entity, see Applicable entity making an elective payment Qualified carbon oxide. This is (a) any carbon dioxide
election on IRA 2022 credits in the Instructions for Form captured from an industrial source by equipment originally
3800. For more information on elective payment elections placed in service before February 9, 2018, which would
under section 6417, see Elective Payment of Certain otherwise be released into the atmosphere as industrial
Business Credits Under Section 6417 or Section 48D in emission of greenhouse gas or lead to such release, and
the Instructions for Form 3800. is measured at the source of capture and verified at the
If you’re an applicable entity, your election to treat the point of disposal, injection, or utilization; (b) any carbon
credit as a payment generally applies to 2023 and any dioxide or other carbon oxide that’s captured from an
subsequent year during the 12-year period described in industrial source by equipment originally placed in service
section 45Q(3)(A) or (4)(A) for such equipment. You must on or after February 9, 2018, which would otherwise be
obtain an IRS-issued registration number for the released into the atmosphere as industrial emission of
equipment in 2023 and each of the succeeding years. greenhouse gas or lead to such release, and is measured
at the source of capture and verified at the point of
Taxpayers electing to be treated as applicable enti- disposal, injection, or utilization; or (c) in the case of a
ties. If you aren’t an applicable entity, you can also elect DAC facility, any carbon dioxide that’s captured directly
to treat the credit as a payment of taxes on your return. from the ambient air, and is measured at the source of
Section 6417(d)(1)(C) allows an electing taxpayer, capture and verified at the point of disposal, injection, or
including partnership and S corporation under section utilization.
6417(c), to treat the credit for a facility or equipment
installed in a facility and placed in service after 2022 as a Qualified carbon oxide includes the initial deposit of
payment or deemed payment of taxes. captured carbon oxide used as a tertiary injectant. It
doesn’t include carbon oxide that’s recaptured, recycled,
For a discussion of who is considered an electing and re-injected as part of the EOR and natural gas
taxpayer, see the Instructions for Form 3800. For more recovery process.
information on elective payment elections under section
6417, see Elective Payment of Certain Business Credits Carbon capture equipment. This includes all
Under Section 6417 or Section 48D in the Instructions for components of property that are used to capture or
Form 3800. process carbon oxide until the carbon oxide is transported
for disposal, injection, or utilization. Carbon capture
If you make a section 6417(d)(1)(C) election, the
equipment is equipment used for the purpose of (1)
election generally applies to 2023 and the 4 succeeding
separating, purifying, drying, and/or capturing carbon
years (unless you revoke your election).
oxide that would otherwise be released into the
If you’re a partnership or an S corporation that atmosphere from an industrial facility; (2) removing carbon
! elected to treat the credit for a new facility or oxide from the atmosphere via DAC; or (3) compressing or
CAUTION equipment as a payment of taxes, you must report otherwise increasing the pressure of carbon oxide.
the total credit amount on Form 3800. See the specific All components that make up an independently
instructions for line 21 of Part III. functioning process train capable of capturing,
processing, and preparing carbon oxide for transport will
Credit transfers. For tax years beginning after 2022,
be treated as a single unit of equipment (single process
under section 6418, eligible taxpayers, partnerships, and
train). See Rev. Rul. 2021-13, 2021-30 I.R.B. 152,
S corporations can elect to transfer all or part of the credit
available at IRS.gov/irb/2021-30_IRB#REV-RUL-2021-13.
for a new or existing facility or equipment to an unrelated
third-party buyer in exchange for cash. For more Applicable electric generating unit. An applicable
information on credit transfers, see Transfer of Eligible electric generating unit is the principal electric generating
Credits Under Section 6418 in the Instructions for Form unit for which the equipment is originally planned and
3800. designed.
If you’re a partnership or S corporation electing to Baseline carbon oxide production. A baseline carbon
oxide production means either of the following.
! transfer the credit (or portion thereof), you must
CAUTION report the total credit amount on Form 3800. See • In the case of an applicable electric generating unit that
specific instructions for line 21 of Part III. was originally placed in service more than 1 year prior to
the date on which construction of the equipment begins,
Pre-filing registration requirement for payments or the average annual carbon oxide production, by mass,
transfers. Before you file your tax return, if you intend to from such unit during (i) in the case of an applicable
make an elective payment election or transfer election on electric generating unit that was originally placed in
Form 3800 for the credit figured in Part III, you must service more than 1 year prior to the date on which
complete a pre-filing registration for each facility. To construction of the equipment begins and on or after the
register, go to IRS.gov/Register for elective payment or date that’s 3 years prior to the date on which construction

Instructions for Form 8933 (Rev. 12-2023) 3

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of such equipment begins, the period beginning on the 1. In the case of a DAC facility, captures not less than
date such unit was placed in service and ending on the 1,000 metric tons of qualified carbon oxide during the tax
date on which construction of such equipment began; and year;
(ii) in the case of an applicable electric generating unit that 2. In the case of an electricity generating facility that (i)
was originally placed in service more than 3 years prior to captures not less than 18,750 metric tons of qualified
the date on which construction of the equipment begins, carbon oxide during the tax year; and (ii) for any carbon
the 3 years with the highest annual carbon oxide capture equipment for the applicable electric generating
production during the 12-year period preceding the date unit at such facility, has a capture design capacity of not
on which construction of such equipment began. less than 75% of the baseline carbon oxide production of
• In the case of an applicable electric generating unit that such unit; or
(i) as of the date on which construction of the equipment
3. In the case of any other facility, captures not less
begins, is not yet placed in service; or (ii) was placed in
than 12,500 metric tons of qualified carbon oxide during
service during the 1-year period prior to the date on which
the tax year.
construction of the equipment begins, the designed
annual carbon oxide production, by mass, as determined Qualified EOR or natural gas recovery project. An
based on an assumed capacity factor of 60%. EOR or natural gas recovery project means any project
Capacity factor. Capacity factor means the ratio located in the United States involving the application of
(expressed as a percentage) of the actual electric output one or more tertiary recovery methods defined in section
from the applicable electric generating unit to the potential 193(b)(3) that can reasonably be expected to result in
electric output from such unit. more than an insignificant increase in the amount of crude
Industrial facility. An industrial facility is a facility that oil or natural gas that will ultimately be recovered and for
produces a carbon oxide stream from a fuel combustion which the first injection of liquids, gases, or other matter
source or fuel cell, a manufacturing process, or a fugitive begins after 1990.
carbon oxide emission source that, absent capture and Natural gas. Natural gas means any product (other than
disposal, would otherwise be released into the crude oil) of an oil or gas well if a deduction for depletion is
atmosphere as industrial emission of greenhouse gas or allowable under section 611 for such product.
lead to such release. An industrial facility doesn’t include a
facility that produces carbon dioxide from carbon dioxide Tertiary injectant. An injectant (other than a
production wells at natural carbon dioxide-bearing hydrocarbon injectant that’s recoverable) that’s used as
formations or a naturally occurring subsurface spring. part of a tertiary recovery method. For more details, see
Depending on your election to use the June 2020 Notice section 193(b).
of Proposed Rulemaking (NPRM) or the TD, see section Secure geological storage. Secure geological storage
3.02(b) of Notice 2009-83 or Proposed Regulations includes, but isn’t limited to, storage at deep saline
section 1.45Q-2(d)(1) or Regulations section 1.45Q-2(d) formations, oil and gas reservoirs, and unminable coal
(1) and (d)(2). An Industrial Source is an emission of seams.
carbon oxide from an industrial facility. A Manufacturing If you’re claiming a credit for a facility placed in service
Process is a process involving the manufacture of before February 9, 2018, the following applies.
products, other than carbon oxide, that are intended to be Secure geological storage requires approval by the U.S.
•
sold at a profit, or are used for a commercial purpose. All Environmental Protection Agency (EPA) of a Monitoring,
facts and circumstances for the process and products are Reporting, and Verification Plan (MRV Plan) submitted by
to be taken into account. the operator of the storage facility or tertiary injection
Electricity generating facility. An electricity generating project.
facility is a facility described in section 45Q(d)(2)(A) or (B) • The annual amount of carbon oxide claimed for the
and is subject to depreciation under MACRS asset class credit must be consistent with amounts reported to the
49.11 (Electric Utility Hydraulic Production Plant), 49.12 EPA under its Greenhouse Gas Reporting Program,
(Electric Utility Nuclear Production Plant), 49.13 (Electric subpart RR.
Utility Steam Production Plant), or 49.15 (Electric Utility See Sections 6 through 8 of Notice 2009-83, 2009-44
Combustion Turbine Production Plant). I.R.B. 588, available at IRS.gov/irb/
Direct air capture (DAC) facility. A DAC facility means 2009-44_IRB#NOT-2009-83 for reporting and
any facility that uses carbon capture equipment to capture recordkeeping requirements associated with the limitation
carbon oxide directly from the ambient air. It doesn’t on credits available under former section 45Q(a) (as in
include any facility that captures carbon dioxide (1) that’s effect before February 9, 2018) and sections 45Q(a)(1)
deliberately released from naturally occurring subsurface and (2). Sections 1 through 5 of Notice 2009-83 were
springs, or (2) using natural photosynthesis. obsoleted by REG-112339-19, 85 F.R. 34050-34075. After
the end of the calendar year in which the Secretary, in
Facility. Any industrial facility or DAC facility (a) the consultation with the Administrator of the EPA, certifies
construction of which begins before January 1, 2033, and that a total of 75,000,000 metric tons of qualified carbon
the construction of carbon capture equipment begins oxide have been taken into account under former section
before that date, or the original planning and design for the 45Q(a) (as in effect before February 9, 2018) and sections
facility includes installation of carbon capture equipment; 45Q(a)(1) and (2), the remaining sections of Notice
and (b) which captures: 2009-83 will be obsoleted. Also see Notice 2022-38,

4 Instructions for Form 8933 (Rev. 12-2023)

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2022-39 I.R.B. 239, available at IRS.gov/irb/                   Section 45Q(f)(6) Election
2022-39_IRB#NOT-2022-38.                                        For purposes of section 45Q, for any tax year in which 
  If you’re claiming a credit for a facility that was placed in such facility is an applicable facility (a facility placed in 
service in tax years beginning on or after February 9,          service before February 9, 2018, and for which no 
2018, qualified carbon oxide is considered disposed of by       taxpayer claimed a section 45Q credit for any tax year 
you in secure geological storage such that the qualified        ending before February 9, 2018) that captures not less 
carbon oxide doesn’t escape into the atmosphere if the          than 500,000 metric tons of qualified carbon oxide during 
qualified carbon oxide is:                                      the tax year, you can elect to have the facility, and any 
• Stored, and not used as a tertiary injectant in an EOR or     equipment placed in service at the facility, treated as 
natural gas recovery project, in compliance with                placed in service on February 9, 2018.
applicable requirements under 40 CFR Part 98 subpart 
RR;                                                             You can make a section 45Q(f)(6) election by filing a 
• Used as a tertiary injectant in an EOR or natural gas         statement of election with your income tax return for each 
recovery project and stored in compliance with applicable       tax year in which the credit arises. In addition to any 
requirements under 40 CFR Part 98 subpart RR, or the            information required on Form 8933, your statement of 
International Organization for Standardization (ISO)            election must show your name, address, taxpayer 
standards endorsed by the American National Standards           identification number, location, and the identification 
Institute (ANSI) under CSA/ANSI ISO 27916:19, Carbon            number(s) assigned to the facility by the EPA's electronic 
dioxide capture, transportation and geological                  Greenhouse Gas Reporting Tool (e-GGRT ID number(s)) 
storage—Carbon dioxide storage using enhanced oil               (if available).

recovery (CO2-EOR); and                                         Note. EPA e-GGRT ID number(s) are identification 
• Injected into a well that complies with applicable            number(s) assigned to the facility by the EPA's electronic 
Underground Injection Control regulations onshore or            Greenhouse Gas Reporting Tool.
offshore under submerged lands within the territorial 
jurisdiction of the United States.                              Section 45Q(f)(3)(B) Election
Utilization of qualified carbon oxide. Utilization of           In the case of qualified carbon oxide captured using 
qualified carbon oxide means (1) the fixation of such           equipment that’s originally placed in service at a facility 
qualified carbon oxide through photosynthesis or                before February 9, 2018, if you’re the person that captures 
chemosynthesis, such as through the growing of algae or         and physically or contractually ensures the disposal, 
bacteria; (2) the chemical conversion of such qualified         injection, or utilization of the qualified carbon oxide, the 
carbon oxide to a material or chemical compound in which        credit is attributable to you. You may claim the credit, or 
such qualified carbon oxide is securely stored; or (3) the      you may elect to allow the credit to the person that 
use of such qualified carbon oxide for any other purpose        disposes of, injects, or utilizes the qualified carbon oxide. 
for which a commercial market exists (with the exception        If you make this election, the amount you elect to allow 
of use as a tertiary injectant in an EOR or natural gas         won’t be allowed to you. You can also elect to allow only 
recovery project), as determined by the Secretary of the        part of the credit to the person that disposes of, injects, or 
Treasury or her delegate.                                       utilizes the qualified carbon oxide in a tax year, and to 
United States and U.S. territories. This includes the           claim the remainder yourself.
seabed and subsoil of those submarine areas that are            In the case of qualified carbon oxide captured using 
adjacent to the territorial waters of the United States (or a   equipment that’s originally placed in service at a facility on 
U.S. territory) and over which the United States has            or after February 9, 2018, if you’re the person that owns 
exclusive rights, in accordance with international law, for     the equipment and physically or contractually ensures the 
the exploration and exploitation of natural resources.          capture and disposal, utilization, or use as a tertiary 
                                                                injectant of such carbon oxide, you may check the box to 
Who Can Claim the Credit                                        elect to allow the credit to another person that disposes of, 
The credit is attributable to you in the case of qualified      injects, or utilizes the qualified carbon oxide. If you make 
carbon oxide captured using equipment that’s originally         this election, the amount you elect to allow won’t be 
placed in service at a facility on or after February 9, 2018,   allowed to you. You can also elect to allow only part of the 
if you’re the person that owns the equipment and                credit to the person that disposes of, injects, or utilizes the 
physically or contractually ensures the disposal, utilization,  qualified carbon oxide in a tax year, and to the claim the 
or use as a tertiary injectant of this qualified carbon oxide.  remainder yourself.
Elections                                                       A new section 45Q(f)(3)(B) election must be made 
                                                                annually. You make a section 45Q(f)(3)(B) election by 
Section 45Q(b)(3) Election                                      filing a statement of election (see Model Certificate 
You can elect to have the credit rates applicable to Part III,  ELECT, later, and the information below) with the Form 
lines 1b, 2b, 3b, 4b, 5b, and 6b apply instead of the           8933 no later than the time prescribed by law (including 
applicable dollar amounts applicable to Part III, lines 7b,     extensions) for filing your federal income tax return or 
8b, 9b, 10b, 11b, 12b, 13b, 14b, and 15b for each metric        Form 1065, U.S. Return of Partnership Income, for the 
ton of qualified carbon oxide that’s captured by you using      year in which the credit arises. You must make a separate 
equipment that’s originally placed in service at a facility on  election for each facility.
or after February 9, 2018.

Instructions for Form 8933 (Rev. 12-2023)                                                                                     5

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        The election may not be filed with an amended         • The dollar amount of credits that each electing taxpayer 
  !     federal income tax return, an amended Form            is allowing the credit claimant to claim and the 
CAUTION 1065, or an Administrative Adjustment Request         corresponding metric tons of carbon oxide; and
(AAR), as applicable, after the prescribed date (including    • A copy of the electing taxpayer’s Form 8933.
extensions) for filing the original federal income tax return 
or Form 1065 for the year, with the exception of amended      Section 45Q(f)(9) Election
federal income tax returns, amended Forms 1065, or            For purposes of section 45Q(a)(3) and (4), a person 
AARs, as applicable, for any tax year ending after            described in section 45Q(f)(3)(A)(ii) may elect, at such 
February 9, 2018, and beginning on or before January 13,      time and in such manner as the Secretary may prescribe, 
2021. The amended federal income tax return or the            to have the 12-year period begin on the first day of the first 
amended Form 1065 must be filed, in no event, later than      tax year in which a credit under this section is claimed for 
the applicable period of limitations on assessment for the    equipment that’s originally placed in service at a facility on 
tax year for which the amended federal income tax return      or after February 9, 2018, if:
or Form 1065 is being filed.                                  • No one claimed a credit under this section for such 
                                                              equipment for any prior tax year;
Information required to be provided by electing tax-          • The facility at which such equipment is placed in 
payer.                                                        service is located in an area affected by a federally 
• Election statement of the electing taxpayer on Form         declared disaster (as defined by section 165(i)(5)(A)) after 
8933 must indicate that an election is being made under       the equipment is originally placed in service; and
section 45Q(f)(3)(B);                                         • Such federally declared disaster results in a cessation 
• The electing taxpayer must provide each credit claimant     of the operation of the facility or the equipment after such 
with a copy of the electing taxpayer’s Form 8933; and         equipment is originally placed in service.
• The electing taxpayer must, in addition to any 
information required on Form 8933, set forth the following    Application of Section 45Q for Certain 
information.
                                                              Carbon Capture Equipment
  1. The electing taxpayer’s name, address, taxpayer          In the case of any equipment placed in service before 
identification number, location, and e-GGRT ID number(s)      February 9, 2018, the credit will apply to qualified carbon 
(if available) of each facility where carbon oxide was        oxide captured using such equipment before the end of 
captured;                                                     the calendar year in which the Secretary, in consultation 
  2. The full amount of credit attributable to the taxpayer   with the Administrator of the EPA, certifies that, during the 
prior to the election;                                        period beginning after October 3, 2008, a total of 
  3. The name, address, and taxpayer identification           75,000,000 metric tons of qualified carbon oxide have 
number of each credit claimant, and the location and EPA      been taken into account in accordance with section 
e-GGRT ID number(s) (if available) of each secure             45Q(a), as in effect on the day before February 9, 2018, 
geological storage facility where the qualified carbon        and section 45Q(a)(1) and (2).
oxide is disposed of or injected;                               Effective August 16, 2022, in the case of any 
  4. The dollar amount of credits the taxpayer is allowing    equipment placed in service before February 9, 2018, the 
each credit claimant to claim and the corresponding           credit will apply to qualified carbon oxide captured using 
metric tons of qualified carbon oxide; and                    such equipment before the earlier of January 1, 2023, and 
  5. The dollar amount of credits retained by the electing    the end of the calendar year in which the Secretary, in 
taxpayer and the corresponding metric tons of qualified       consultation with the Administrator of the EPA, certifies 
carbon oxide.                                                 that during the period beginning after October 3, 2008, a 
                                                              total of 75,000,000 metric tons of qualified carbon oxide 
Information required to be provided by credit claim-          have been taken into account in accordance with section 
ant. The credit claimant must include the following           45Q(a), as in effect on the day before February 9, 2018, 
information on Form 8933 with its timely filed federal        and section 45Q(a)(1) and (2). See section 45Q(g) as 
income tax return or Form 1065 (including extensions).        amended by IRA22 and Notice 2022-38.
• The name, address, and taxpayer identification number 
of the credit claimant;                                       When Construction Begins
• The name, address, and taxpayer identification number       Two methods can be used to establish that construction of 
of each taxpayer making an election under section 45Q(f)      a facility or equipment has begun.
(3)(B) to allow the credit to the credit claimant;
• The location and EPA e-GGRT ID number(s) (if                  1. Physical Work Test is satisfied when physical work 
available) of each facility where carbon oxide was            of a significant nature begins and other requirements 
captured;                                                     provided in Section 5 of Notice 2020-12, 2020-11 I.R.B. 
• The location and EPA e-GGRT ID number(s) (if                495, available at IRS.gov/irb/2020-11_IRB#NOT-2020-12, 
available) of each secure geological storage facility where   are met.
the qualified carbon oxide is disposed of or injected;          2. Five Percent Safe Harbor is satisfied when you 
• The full dollar amount of credits attributable to each      pay or incur (within the meaning of Regulations section 
electing taxpayer prior to the election and the               1.461-1(a)(1) and (2)) 5% or more of the total cost of a 
corresponding metric tons of carbon oxide;                    facility or equipment and meets other requirements 
                                                              provided in Notice 2020-12, Section 6.

6                                                                               Instructions for Form 8933 (Rev. 12-2023)

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  Although both methods can be used, only one method           • The number of workers who received correction 
is needed to establish that construction of a facility or      payments.
equipment has begun. If you began construction on a            • The wages paid and hours worked by qualified 
facility or equipment by satisfying either the Physical Work   apprentices for each of the laborer or mechanic 
Test or the Five Percent Safe Harbor, or both, before the      classifications engaged in the construction (alteration or 
effective date of Notice 2020-12 (March 9, 2020), you may      repairs) of the facility or equipment.
use March 9, 2020, as the date that construction began on      • The total labor hours for the construction (alteration or 
such facility or equipment. Additionally, if you began         repairs) of the facility or equipment installed at a facility by 
construction on a facility or equipment before March 9,        any laborer or mechanic employed by the taxpayer or any 
2020, under both the Physical Work Test and the Five           contractor or subcontractor.
Percent Safe Harbor, you may choose either method (but           4. A declaration, applicable to the statement and any 
not both) for the purpose of applying the beginning of         accompanying documents, signed by you, or signed by a 
construction rules. If you began construction on a facility    person currently authorized to bind you in such matters, in 
or equipment on or after March 9, 2020, construction will      the following form: “Under penalties of perjury, I declare 
be deemed to have begun on the date you first satisfy          that I have examined this statement, including 
either the Physical Work Test or the Five Percent Safe         accompanying documents, and to the best of my 
Harbor. If you fail to satisfy the Five Percent Safe Harbor in knowledge and belief, the facts presented in support of 
one year due to cost overruns (as defined in Section 6.03      this statement are true, correct, and complete.”
of Notice 2020-12), you won’t be prevented from using the 
Physical Work Test in a later year to establish beginning of     Applicable wage determinations mean the wage 
construction, provided that occurs before January 1, 2033.     listed for a particular classification of laborer or mechanic 
                                                               on the applicable wage determination for the type of 
Increased Credit Amount for Facilities                         construction and the geographic area or other applicable 
                                                               wage as determined by the Secretary of Labor. See 
and Equipment
                                                               Notice 2022-61 for more information.
Notice 2022-61 explains how claimants, including 
taxpayers, tax-exempt and government entities, and             Prevailing Wage Requirements
non-taxable pass-through entities, receive increased           For any facility and any equipment placed in service at 
credit amount for any facility or equipment placed in          such facility, you must ensure that any laborers and 
service after 2022, by satisfying certain requirements. In     mechanics employed by you or any contractor or 
the case of any facility or equipment installed in any         subcontractor in (i) the construction of such facility or 
facility, the amount of the credit rates as adjusted for       equipment, and (ii) for any tax year, for any portion of such 
inflation or applicable dollar amounts are multiplied by 5 if  tax year that’s within the period described in section 
any one of the following requirements are met.                 45Q(a)(3)(A) or (4)(A), the alteration or repair of such 
• A facility the construction of which began prior to          facility or such equipment, must be paid wages at rates 
January 29, 2023;                                              not less than the prevailing rates for construction, 
• Carbon equipment the construction of which began             alteration, or repair of a similar character in the locality in 
prior to January 29, 2023, and installed in a facility; or     which such facility and equipment are located as most 
• A facility or equipment that satisfies the prevailing wage   recently determined by the Secretary of Labor, in 
and apprenticeship requirements.                               accordance with subchapter IV of chapter 31 of title 40, 
Additional information. If you checked the box and             United States Code. See Notice 2022-61 for details.
claimed an increased credit amount on lines 4a, 5a, 6a,          For information on how to correct a failure to satisfy the 
10a, 11a, 12a, 13a, 14a, or 15a in Part III, you must attach   prevailing wage requirements, and the penalty related to 
a statement to Form 8933 that includes the following           the failure, see section 45(b)(7)(B) and Section 3 of Notice 
information.                                                   2022-61.
  1. Your name and taxpayer identification number and 
the facility or equipment description and IRS-issued           Apprenticeship Requirements
registration number (if applicable) from Part II.              To meet the apprenticeship requirements, you must 
  2. If construction began before January 29, 2023, as         ensure that, for the construction of any qualified facility, 
shown on Part II, line 5, a statement that you met the         not less than the applicable percentage of the total labor 
Continuity Requirement under the Physical Work Test or         hours of the construction, alteration, or repair work 
the Five Percent Safe Harbor to establish the beginning of     (including such work performed by any contractor or 
construction (alteration or repairs).                          subcontractor) for such facility is, subject to section 45(b)
                                                               (8)(B), performed by qualified apprentices (apprenticeship 
  3. If construction began on or after January 29, 2023, 
                                                               labor hour requirements). The apprenticeship 
include the following.
                                                               requirements include three components: a labor-hours 
• The applicable wage determinations (as defined 
                                                               requirement, a ratio requirement, and a participation 
below).
                                                               requirement.
• The wages paid (including any correction payments as 
defined in section 45(b)(7)(B)(i)(I)) and hours worked for     • You must ensure that, depending on when construction 
                                                               began, 12.5% or 15% of the total labor-hours performed in 
each of the laborer or mechanic classifications engaged in 
                                                               the construction, alteration, or repair of the facility are 
the construction (alteration or repairs) of the facility or 
                                                               performed by qualified apprentices from a registered 
equipment.
                                                               apprenticeship program.

Instructions for Form 8933 (Rev. 12-2023)                                                                                      7

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• You must ensure that the applicable ratio of apprentices      project for any tax year is reduced by the amount that's the 
to journeyworkers established by the registered                 product of the credit for such tax year and the lesser of 
apprenticeship program are met for apprentices working          50% or a fraction, the numerator of which is the sum, for 
on the facility each day.                                       the tax year and all prior tax years, of the proceeds from 
• Any taxpayer (or contractor or subcontractor) that            an issue described in section 142(a)(17) used to provide 
employs 4 or more laborers or mechanics in the                  financing for the project the interest on which is exempt 
construction, alteration, or repair of the facility must also   from tax under section 103, and the denominator of which 
hire at least one qualified apprentice.                         is the aggregate amount of additions to the capital 
                                                                account for the project for the tax year and all prior tax 
Beginning of construction. See Sections 2 and 5 of 
                                                                years. The amounts under the preceding sentence for any 
Notice 2022-61 and When Construction Begins, earlier, to 
                                                                tax year are determined as of the close of the tax year.
establish whether construction of a facility or equipment at 
a facility began before January 29, 2023.                       Note. For purposes of the above, there’re no prior tax 
Recapture                                                       years before January 1, 2022.

A recapture event occurs when qualified carbon oxide for        Reporting Requirements
which a credit has been claimed ceases to be captured, 
disposed of, or used as a tertiary injectant during the         General Requirements
recapture period. Recapture events are determined               If you’re claiming the credit, you must provide the name 
separately for each project involving capture, disposal, or     and location of the facilities at which the qualified carbon 
use of qualified carbon oxide as a tertiary injectant.          oxide was captured.
  Qualified carbon oxide ceases to be captured,                         If you’re claiming the credit on an amended federal 
disposed of, or used as a tertiary injectant if the leaked        !     income tax return, an amended Form 1065, or an 
amount of qualified carbon oxide in the tax year exceeds        CAUTION AAR, as applicable, you must state “AMENDED 
the amount of qualified carbon oxide disposed of in             RETURN FOR SECTION 45Q CREDIT” at the top of your 
secure geological storage or used as a tertiary injectant in    amended federal income tax return, amended Form 1065, 
that same tax year.                                             or AAR, as applicable. Your amended federal income tax 
                                                                return or the amended Form 1065 must be filed, in no 
  If a recapture event occurs during a project’s recapture      event, later than the applicable period of limitations on 
period and you have claimed a credit for that project, you      assessment for the tax year for which your amended 
must report the following information on a Form 8933 filed      federal income tax return or Form 1065 is being filed.
with your federal income tax return or Form 1065 for the 
tax year for which the recapture event occurred.
• The recapture amount (as defined in Regulations               Contractually Ensuring Disposal, Injection, or 
section 1.45Q-5(e));                                            Utilization of Qualified Carbon Oxide
• The quantity of leaked qualified carbon oxide (in metric      If you enter into a contract with another party to ensure 
tons) (as defined in Regulations section 1.45Q-5(c));           disposal, injection, or utilization of qualified carbon oxide, 
• The statutory credit rate at which the credits were           you must report the existence of each contract, and the 
originally calculated; and                                      parties involved annually on Form 8933 by each party to 
• A statement that describes how you became aware of            the contract, regardless of the party claiming the credit. In 
the recapture event, how the leaked amount was                  addition to any information stated as required on Form 
determined, and the identity and involvement of any             8933, the report must include the following information.
regulatory agencies.                                            • Your name and identifying number;
                                                                • The name and taxpayer identification number of each 
Credit Reduced for Tax-Exempt Bond                              party with whom you have entered into a contract to 
Financing                                                       ensure the disposal, injection, or utilization of qualified 
                                                                carbon oxide;
For facilities or equipment placed in service after 2022, 
the credit is reduced by an amount that is the product of       • The date on which each contract was executed;
the credit amount otherwise determined for the tax year         • The number of metric tons of qualified carbon oxide 
                                                                each contracting party disposes of, injects, or utilizes on 
and the lesser of 15% or a fraction determined for the tax 
                                                                behalf of you each tax year for reporting to the IRS; and
year. The numerator of the fraction is the sum, for the tax 
year and all prior tax years, of the proceeds from an issue     • For contracts for the disposal of qualified carbon oxide 
                                                                in secure geological storage or the use of qualified carbon 
of any obligations the interest of which is exempt from tax 
                                                                oxide as a tertiary injectant in EOR or natural gas 
under section 103 and that is used to provide financing for 
                                                                recovery, identifying information (the name of the operator, 
the facility as of the close of the tax year. The denominator 
                                                                field, unit, and reservoir), location by county and state, 
of the fraction is the aggregate amount of additions to the 
                                                                and EPA e-GGRT ID number(s) (if available) for 
capital account for the facility for the tax year and all prior 
                                                                submission of the facility’s 40 CFR Part 98 (subpart RR) 
tax years as of the close of the tax year.
                                                                annual reports.
Coordination With Section 142 Bond 
                                                                Secure Geological Storage
Financing                                                       Certifications must be made annually.
For facilities or equipment placed in service before 2023 
and obligations issued after 2021, the credit for any 

8                                                                              Instructions for Form 8933 (Rev. 12-2023)

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Reporting Based on 40 CFR Part 98 (Subpart RR)                 For purposes of a natural gas project, a petroleum 
                                                               engineer's certification as required under Regulations 
For an EOR or natural gas recovery project in which you        section 1.43-3(a)(3) and an operator's continued 
reported volumes to the EPA pursuant to 40 CFR Part 98         certification of a project as required under Regulations 
subpart RR, you may self-certify the volume of carbon          section 1.43-3(b)(3) must include an additional statement 
oxide claimed for purposes of the credit.                      that the certification is for purposes of the credit.

Reporting Based on CSA/ANSI ISO 27916:19                       Petroleum Engineer’s Certification

For an EOR or natural gas recovery project in which you        The petroleum engineer's certification must be attached to 
determined volumes pursuant to CSA/ANSI ISO                    a Form 8933 and filed no later than the last date 
27916:19, you may prepare documentation as outlined in         prescribed by law (including extensions) for filing the 
CSA/ANSI ISO 27916:19 internally, but such                     operator's or designated owner's federal income tax return 
documentation must be provided to a qualified                  or Form 1065 for the first tax year in which qualified 
independent engineer or geologist, who then must certify       carbon oxide is injected into the reservoir.
that the documentation provided, including the mass 
balance calculations as well as information regarding                  If a credit is claimed on an amended federal 
monitoring and containment assurance, is accurate and          !       income tax return, an amended Form 1065, or an 
complete. For any leaked amount of qualified carbon            CAUTION AAR, as applicable, the petroleum engineer's 
oxide that’s determined pursuant to CSA/ANSI ISO               certification will be treated as filed timely if it’s attached to 
27916:19, the certification must also include a statement      a Form 8933 that’s submitted with such amended federal 
that the quantity was determined in accordance with            income tax return, amended Form 1065, or AAR. For a 
sound engineering principles.                                  credit that’s claimed on a timely filed federal income tax 
                                                               return or Form 1065 for a tax year ending after February 9, 
If you capture qualified carbon oxide to get the credit,       2018, and beginning on or before January 13, 2021, for 
you must file Form 8933 with your timely filed federal         which the petroleum engineer's certification wasn’t 
income tax return or Form 1065, including extensions, or       submitted, the petroleum engineer's certification will be 
for the purpose of this rule, your amendments to federal       treated as filed timely if it’s attached to an amended Form 
income tax returns, Forms 1065, or on AARs, as                 8933 for any tax year ending after February 9, 2018, but 
applicable. Similarly, if you dispose of, inject, or utilize   not for tax years beginning on or before January 13, 2021.
qualified carbon oxide, you must also file Form 8933 with 
your timely filed federal income tax return or Form 1065, 
                                                               Operator’s Continued Certification
including extensions, or for the purpose of this rule, your 
amendments to federal income tax returns, Forms 1065, 
or on AARs, as applicable. If the volume of carbon oxide       The operator's continued certification of a project must be 
certified and reported is a negative amount, see               attached to a Form 8933 and filed no later than the last 
Regulations section 1.45Q-5 for rules regarding recapture.     date prescribed by law (including extensions) for filing the 
                                                               operator's or designated owner's federal income tax return 
        No credit is allowed for any tax year for which you    or Form 1065 for tax years after the tax year for which the 
!       (including credit claimants) have failed to timely     petroleum engineer's certification is filed but not after the 
CAUTION submit complete documentation, including the           tax year in which injection activity ceases and all injection 
required certifications. The credit will be allowed only for a wells are plugged and abandoned.
tax year for which complete documentation and 
certification has been timely submitted. Certifications for    Utilization
each tax year must be submitted by the due date of your        The amount of qualified carbon oxide utilized by you is 
federal income tax return or Form 1065 on which the credit     equal to the metric tons of qualified carbon oxide that you 
is claimed, including extensions. If your credit is claimed    demonstrate, based upon an analysis of lifecycle 
on your amended federal income tax return, amended             greenhouse gas emissions (LCA), that were captured and 
Form 1065, or AAR, as applicable, certifications may also      permanently isolated from the atmosphere (isolated), or 
be submitted with your amended federal income tax              displaced from being emitted into the atmosphere 
return, amended Form 1065, or AAR. If a credit was             (displaced).
claimed on your timely filed federal income tax return or 
Form 1065 for a tax year ending after February 9, 2018,        Lifecycle greenhouse gas emissions and lifecycle 
and beginning on or before January 13, 2021, for which         analysis. The term “lifecycle greenhouse gas emissions” 
certifications weren’t submitted, such certifications may be   means the aggregate quantity of greenhouse gas 
submitted with your amended federal income tax return,         emissions (including direct emissions and significant 
amended Form 1065, or AAR, as applicable, for the tax          indirect emissions such as significant emissions from land 
year in which the credit was claimed.                          use changes) related to the full product lifecycle, including 
                                                               all stages of product and feedstock production and 
                                                               distribution, from feedstock generation or extraction 
Qualified EOR or Natural Gas Recovery Project                  through the distribution and delivery and use of the 
Each qualified EOR or natural gas recovery project must        finished product to the ultimate consumer, where the 
be certified under Regulations section 1.43-3.                 mass values for all greenhouse gases are adjusted to 
                                                               account for their relative global warming potential 
                                                               according to Table A-1 of 40 CFR Part 98 subpart A. The 

Instructions for Form 8933 (Rev. 12-2023)                                                                                 9

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amount of lifecycle greenhouse gas emissions measured of carbon oxide must be measured at the source of
by a lifecycle greenhouse gas analysis (LCA) is expressed capture and verified either at the point of disposal in
in carbon dioxide equivalents (CO2-e). secure geological storage or at the point of injection as a
tertiary injectant in an EOR or natural gas recovery
Measurement. The measurement and written LCA report
project. The amount of qualified carbon oxide is presumed
must be performed by or verified by an independent third
to be the lesser of the amount measured at capture and
party. The LCA report must be prepared in conformance
the amount verified at disposal or injection unless it can
with, and contain documentation that conforms to, the
be established to the satisfaction of the IRS that the
International Organization for Standardization (ISO)
greater amount is the correct amount.
14040:2006, Environmental Management—Life Cycle
Assessment—Principles and Framework, and ISO To claim the credit for utilization of carbon oxide, the
14044:2006, Environmental Management—Life Cycle amount of qualified carbon oxide utilized by you is equal to
Assessment—Requirements and Guidelines, as well as a the metric tons of qualified carbon oxide that you
statement documenting the qualifications of the demonstrate, based upon an analysis of lifecycle
independent third party, including proof of appropriate greenhouse gas emissions (LCA), were (1) captured and
U.S. or foreign professional license, and an affidavit from permanently isolated from the atmosphere, or (2)
the third party stating that it's independent from you. displaced from being emitted into the atmosphere. The
Approval of the LCA. You must submit the written LCA amount of qualified carbon oxide utilized by you for
report and independent third-party statement to the IRS purposes of the credit can't exceed the amount of
and the Department of Energy (DOE). The LCA will be qualified carbon oxide measured at the source of capture.
subject to a technical review by the DOE, and the IRS will
determine whether to approve the LCA. Part I. Information About You
You should fax a copy of your LCA report, including the Line 1. See Lifecycle greenhouse gas emissions and
independent third-party statement specified in lifecycle analysis, earlier.
Regulations section 1.45Q-4(c)(4), to the IRS at Line 2. See Qualified carbon oxide, earlier.
844-255-4817. The submission should include a cover
letter with: Lines 4 and 5. See Section 45Q(f)(3)(B) Election, earlier.

1. Name of the facility where the qualified carbon Part II. Information About Facility
oxide is utilized (“utilization facility”);
If you’re claiming the credit for a facility or equipment in
2. Name of the operator of the utilization facility, Part III, you must complete Part II.
including operator’s TIN/EIN;
3. Name of the taxpayer(s) claiming the credit based Note. You must also provide information about specific
on the LCA, including each taxpayer's TIN/EIN; industrial facility and equipment in Part I of your model
certificate or version of model certificate. See Model
4. Name of a corporate officer in charge of the LCA
Certificate CF.
report submission (or a designated representative) with a
written power of attorney (POA on Form 2848, Power of Line 1. If applicable, enter your pre-filing registration
Attorney and Declaration of Representative) and that number for the facility that you received from the IRS.
person's contact information, including official corporate Line 3. Enter the type and technical description of the
mailing address; facility or equipment that captured carbon oxide, disposed
5. Tax year in which the credit is claimed; and of carbon oxide, or used carbon oxide as a tertiary
6. Reserved for future use. injectant.
You should also mail (1) the items above, and (2) the Line 4. Enter the address of the facility. If the facility
model, if the LCA wasn’t verified by an independent doesn’t have an address, enter the coordinates of the
third-party review, on a USB thumb drive, to: facility or property (longitude and latitude) on line 4b.
Line 5. Enter the date construction began. See Beginning
Internal Revenue Service
of construction, earlier, for more information.
Office of Associate Chief Counsel (PSI)
1111 Constitution Ave. NW Part III. Credit Calculations
Branch 6 (CC:PSI:6), Room 5114
Washington, DC 20224 Section A—Facilities at Which Qualified Carbon
Oxide Qualifies for a Credit Under Section
You should also send the DOE an email at 45Q(a)(1) or (2) for Which an Election Was Made
LCA45Q@hq.doe.gov, and the DOE will respond with
instructions for submitting the LCA application to the DOE. Under Section 45Q(b)(3)

See Section 45Q(b)(3) Election, earlier.
Specific Instructions Line 1b. Enter $26.94.
To claim the credit for disposal of carbon oxide in secure Line 1c. To see model versions of necessary
geological storage or for use of carbon oxide as a tertiary attachments, see Model Certificate CF Model Certificate ,
injectant in an EOR or natural gas recovery project, prior DISP-Operator, and Model Certificate DISP-Owner. The
to disposal in secure geological sequestration, the amount credit amount on line 1c should be equal to the credit

10 Instructions for Form 8933 (Rev. 12-2023)

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amount shown on Model Certificate CF, Part III, Section A, amount shown on Model Certificate CF, Part III, Section B,
line 1f. line 7f.
Line 2b. Enter $13.47. Line 8b. Enter $27.61.
Line 2c. To see model versions of necessary Line 8. To see model versions of necessary attachments,
attachments, see Model Certificate CF Model Certificate , see Model Certificate CF Model Certificate ,
EOR-Operator, and Model Certificate EOR-Owner. The EOR-Operator, and Model Certificate EOR-Owner. The
credit amount on line 2c should be equal to the credit credit amount on line 8c should be equal to the credit
amount shown on Model Certificate CF, Part III, Section A, amount shown on Model Certificate CF, Part III, Section B,
line 2f. line 8f.
Line 3b. Enter $13.47. Line 9b. Enter $27.61.
Line 3c. To see model versions of necessary Line 9c. To see model versions of necessary
attachments, see Model Certificate CF and Model attachments, see Model Certificate CF and Model
Certificate UTZ. The credit amount on line 3c should be Certificate UTZ. The credit amount on line 9c should be
equal to the credit amount shown on Model Certificate CF, equal to the credit amount shown on Model Certificate CF,
Part III, Section A, line 3f. Part III, Section B, line 9f.
Line 4. If you checked the box on line 4a, enter $134.70 Line 10. If you checked the box on line 10a, see
($26.94 multiplied by 5). See Additional information, Additional information, earlier.
earlier, to claim the increased credit amount.
Line 10c. Enter the credit amount from line 10a or 10b,
If you checked the box on line 4b, enter $26.94. whichever is applicable. To see model versions of
Line 4c. Enter the credit amount from line 4a or 4b, necessary attachments, see Model Certificate CF Model ,
whichever is applicable. To see model versions of Certificate DISP-Operator, and Model Certificate
necessary attachments, see Model Certificate CF Model , DISP-Owner. The credit amount on line 10c should be
Certificate DISP-Operator, and Model Certificate equal to the credit amount shown on Model Certificate CF,
DISP-Owner. The credit amount on line 4c should be Part III, Section B, line 10f.
equal to the credit amount shown on Model Certificate CF, Line 11. If you checked the box on line 11a, see
Part III, Section A, line 4f. Additional information, earlier.
Line 5. If you checked the box on line 5a, enter $67.35 Line 11c. Enter the credit amount from line 11a or 11b,
($13.47 multiplied by 5). See Additional information, whichever is applicable. To see model versions of
earlier, to claim the increased credit amount. necessary attachments, see Model Certificate CF Model ,
If you checked the box on line 5b, enter $13.47. Certificate EOR-Operator, and Model Certificate
EOR-Owner. The credit amount on line 11c should be
Line 5c. Enter the credit amount from line 5a or 5b,
equal to the credit amount shown on Model Certificate CF,
whichever is applicable. To see model versions of
Part III, Section B, line 11f.
necessary attachments, see Model Certificate CF Model ,
Certificate EOR-Operator, and Model Certificate Line 12. If you checked the box on line 12a, see
EOR-Owner. The credit amount on line 5c should be Additional information, earlier.
equal to the credit amount shown on Model Certificate CF, Line 12c. Enter the credit amount from line 12a or 12b,
Part III, Section A, line 5f. whichever is applicable. To see model versions of
Line 6. If you checked the box on line 6a, enter $67.35 necessary attachments, see Model Certificate CF and
($13.47 multiplied by 5). See Additional information, Model Certificate UTZ. The credit amount on line 12c
earlier, to claim the increased credit amount. should be equal to the credit amount shown on Model
If you checked the box on line 6b, enter $13.47. Certificate CF, Part III, Section B, line 12f.

Line 6c. Enter the credit amount from line 6a or 6b, Section C—Qualified Direct Air Capture (DAC)
whichever is applicable. To see model versions of Facilities Under Section 45Q(d)(2)(A) Placed in
necessary attachments, see Model Certificate CF and Service After 2022
Model Certificate UTZ. The credit amount on line 6c
should be equal to the credit amount shown on Model Line 13. If you checked the box on line 13a, see
Certificate CF, Part III, Section A, line 6f. Additional information, earlier.
Line 13c. Enter the credit amount from line 13a or 13b,
Section B. Qualified Facilities Under Section
whichever is applicable. To see model versions of
45Q(a)(3) or (4) for Which No Election Was necessary attachments, see Model Certificate CF Model ,
Made Under Section 45Q(b)(3) Certificate DISP-Operator, and Model Certificate
Line 7b. Enter $40.89. DISP-Owner. The credit amount on line 13c should be
equal to the credit amount shown on Model Certificate CF,
Line 7c. To see model versions of necessary Part III, Section C, line 13f.
attachments, see Model Certificate CF Model Certificate ,
DISP-Operator, and Model Certificate DISP-Owner. The Line 14. If you checked the box on line 14a, see
credit amount on line 7c should be equal to the credit Additional information, earlier.

Instructions for Form 8933 (Rev. 12-2023) 11

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Line 14c. Enter the credit amount from line 14a or 14b, attachments substantially similar to model certificates
whichever is applicable. To see model versions of shown below.
necessary attachments, see Model Certificate CF Model , Model Certificate CF. Use Model Certificate CF if you’re
Certificate EOR-Operator, and Model Certificate the owner of a capture facility (may not be the same entity
EOR-Owner. The credit amount on line 14c should be as the owner of the industrial facility) that emits carbon
equal to the credit amount shown on Model Certificate CF, oxide. Model Certificate CF will help show your share of
Part III, Section C, line 14f. the credit.
Line 15. If you checked the box on line 15a, see Model Certificate DISP-Operator. Use Model
Additional information, earlier. Certificate DISP-Operator if you’re the operator (or
Line 15c. Enter the credit amount from line 15a or 15b, designated operator) of a geologic disposal site at which
whichever is applicable. To see model versions of captured qualified carbon oxide was injected during the
necessary attachments, see Model Certificate CF and calendar year. Don’t use this model certificate if carbon
Model Certificate UTZ. The credit amount on line 15c oxide was injected for enhanced oil or natural gas
should be equal to the credit amount shown on Model recovery. Provide a copy of your signed Model Certificate
Certificate CF, Part III, Section C, line 15f. DISP-Operator to each owner of the disposal site project.
Model Certificate DISP-Owner. Use Model Certificate
Section D—Other Information DISP-Owner if you’re the owner (or one of the owners) of
Line 19e the geologic disposal site at which captured qualified
carbon oxide was injected during the calendar year. The
Subtract line 19d from the total credit reported to you on a operator of the disposal site prepares Table 3 of Model
statement substantially similar to Model Certificate(s) Certificate DISP-Operator. Report the amounts from that
ELECT, Part II, line 6; enter amount on line 19e. Table 3 on lines 11, 12, and 14 through 16.
Attach the applicable model certificates. See Model Model Certificate EOR-Operator. Use Model Certificate
Certificate ELECT Model Certificate EOR-Owner Model , , EOR-Operator if you’re the operator (or designated
Certificate DISP-Owner, and Model Certificate UTZ. operator) of an enhanced oil or gas recovery project (EOR
project) at which captured qualified carbon oxide was
Complete a statement substantially similar to injected during the calendar year. Provide a copy of your
TIP Model Certificate ELECT if you elect under signed Model Certificate EOR-Operator to each owner of
section 45Q(f)(3)(B) to allow another person to the EOR project.
claim your credit. See Model Certificate ELECT, later.
Model Certificate EOR-Owner. Use Model Certificate
Line 20. Enter the total credits on a separate Form 8933 EOR-Owner if you’re the owner (or one of the owners) of
to report your distributive or pro rata share from: the EOR project at which captured qualified carbon oxide
• Schedule K-1 (Form 1065), Partner's Share of Income, was injected during the calendar year. The operator of the
Deductions, Credits, etc., box 15 (code AW); and EOR project prepares Table 3 of Model Certificate
• Schedule K-1 (Form 1120-S), Shareholder's Share of EOR-Operator. Report the amounts from that Table 3 on
Income, Deductions, Credits, etc., box 13 (code AW). lines 11, 12, and 14 through 16.
Enter “Credit from partnerships and S corporations” on Model Certificate UTZ. Use Model Certificate UTZ if
Form 8933, Part II, line 3. All others not using earlier lines you’re the owner of the utilization facility who utilized
to figure a separate credit can report the above credits qualified carbon oxide during the calendar year. Don’t
directly on Form 3800, Part III, line 1x. combine information from separate utilization facilities on
the same Model Certificate UTZ. Provide a copy of your
Line 21. If you’re a partnership or S corporation electing
payment or transfer for the credit for a facility or signed Model Certificate UTZ to each supplier that
equipment, you must report the total credit amount for supplied qualified captured carbon oxide to inform the
your facility or equipment on Form 3800, Part III, line 1x. suppliers of the amount of their qualified carbon oxide that
Don’t report the total credit amount on Schedule K. was utilized.
Line 22. Enter the credit recaptured. Attach a statement Model Certificate ELECT. Use Model Certificate ELECT
substantially similar to Model Certificate(s) RECAPTURE if (1) you’re the owner of the capture facility that supplied
to Form 8933. Report the credit recapture amount on the qualified carbon oxide to another person that was properly
appropriate line of your return. disposed of in geological storage, used in an EOR project,
or utilized in a manner consistent with section 45Q(f), and
Model Certificates (2) you elect under section 45Q(f)(3)(B) to allow the credit
Per the TD and the NPRM that preceded it, if you’re a to that person. You must make a separate election for
large section 45Q project filer, you’ll likely have to use each facility.
multiple legal contracts with multiple parties for the Model Certificate RECAPTURE. Use Model Certificate
capture, utilization, or disposal of carbon oxides and, RECAPTURE if you’re the operator or owner of the
generally to claim the credit, the existence of each geologic disposal site or EOR project to report a recapture
contract and the parties involved must be reported on event.
Form 8933 annually. For this reporting, filers should use

12 Instructions for Form 8933 (Rev. 12-2023)

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                                                                     Model Certificate CF
                                                           Capture Facility Certification                                                                         2023
Name(s) shown on return:                                                                                                           Identifying number:
Part I. Information About Industrial Facility, Carbon Capture Equipment, Carbon Oxide Sequestration Credit, and Elections
                                                                                                                                                                  Yes No
Section 1—Industrial facility information:
1   Name of facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      
2   Location (county and state)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      
3a  IRS-issued registration number(s) for the facility       . . . . . . . . . . . . . . . . . . . . . . . . .      
3b  Facility's EPA e-GGRT ID number(s)*          . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      
4   Is the facility an electricity-generating facility? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5   Is the facility a direct air capture (DAC) facility? If “Yes,” skip to line 12       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6   If the facility isn’t an electricity-generating or DAC facility, state the nature of the facility 
    (for example, ethanol production, cement manufacturing, etc.)              . . . . . . . . . . . . . . . .      
7   What is the placed-in-service date of the facility (MM/DD/YYYY)?                 . . . . . . . . . . . . .      
8   Does the facility described above process carbon dioxide or any other gas from underground deposits?                             . . . . . . . . . . . . . .
8a  If you answered “Yes” to line 8, was any gas obtained from a carbon dioxide production well at natural carbon dioxide-bearing 
    formations or at a naturally occurring subsurface spring, which means a well that contains 90% or greater carbon dioxide by 
    volume?    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8b  If you answered “Yes” to line 8a, you can’t treat the facility as a qualified industrial facility to the extent that it processed gas 
    described in line 8a during the tax year. See line 8c.
8c  If you answered “Yes” to line 8a, do you attest that you meet the exception for a deposit that contains a product, other than carbon 
    oxide, that’s commercially viable to extract and sell without taking into account the availability of a commercial market for the 
    carbon oxide that’s extracted or any credit that might be available? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8d  If you answered “Yes” to line 8c, have you attached an attestment letter from an independent registered engineer? Don’t treat the 
    facility as a industrial facility unless you answered “Yes” to both lines 8c and 8d. See instructions . . . . . . . . . . . . . . . . . . .
9   What were the emissions of carbon oxide during the calendar year (amount released to 
    the atmosphere plus amount captured)?            . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      
9a  Of the amount listed on line 9, what amount was carbon dioxide? . . . . . . . . . . . . . .                     
9b  Of the amount listed on line 9, what amount was carbon monoxide? . . . . . . . . . . . .                        
10  Was annualization of first-year carbon oxide emissions required for this calendar year? . . . . . . . . . . . . . . . . . . . . . . . . .
10a If you answered “Yes” to line 10, state the annualized carbon oxide emissions and attach 
    a statement that shows how you determined the annualized carbon oxide emissions . .                             
11  Was aggregation of multiple facilities required to achieve the requisite carbon capture thresholds?                      . . . . . . . . . . . . . . . . . .
11a If you answered “Yes” to line 11, attach a statement that lists the facilities and describes the appropriateness of their aggregation.
Section 2—Carbon capture equipment and DAC facility information:
12  Is carbon captured by a DAC facility?        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13  State the location of the equipment or DAC facility (county and state)               . . . . . . . . . . .      
14  Was any equipment placed in service prior to February 9, 2018? See instructions                      . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15  What was the placed-in-service date (MM/DD/YYYY) of the equipment or DAC facility 
    described on line 13? See instructions         . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      
16  Are you the owner of the equipment described on line 13?               . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16a If you answered “No” to line 16, state your basis for claiming the credit . . . . . . . . . . .                 
17  For equipment placed in service after February 9, 2018, do you attest that, to the best of your knowledge, you’re the only person 
    who will claim the credit for carbon oxide captured by each single train of equipment during the tax year (irrespective of any 
    election you make to allow a contracting disposer, injector, or utilizer to claim the credit)? Don’t claim the credit unless you can 
    answer “Yes.” See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18  For the equipment described on line 13, what was the carbon capture capacity on or after 
    February 8, 2018?    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      
* If available.
                                                                                                                                                             Model Certificate CF

Instructions for Form 8933 (Rev. 12-2023)                                                                                                                             13

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                                                                                                                                                                       Page 2
Part I. Information About Industrial Facility, Carbon Capture Equipment, Carbon Oxide Sequestration Credit, and Elections 
                                                                                                                                                                       Yes No
(continued)
19  Was additional equipment installed on or after February 9, 2018?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19a For equipment described on line 19, what was the beginning of construction date 
    (MM/DD/YYYY)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              
19b For equipment described on line 19, what was the placed-in-service date (MM/DD/
    YYYY)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         
19c Is the placed-in-service date of the equipment described on line 19 determined pursuant to the 80/20 rule?                            . . . . . . . . . . . . . .
19d If you answered “Yes” to line 19c, state your investment in new equipment and the fair 
    market value of pre-existing equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . .                 
19e If the placed-in-service date of the equipment was determined pursuant to the 80/20 rule, did you include its investment in a 
    transportation pipeline as new equipment?             . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19f If you answered “Yes” to line 19e, state your investment in a transportation 
    pipeline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       
20  What was the total amount of carbon oxide captured during the calendar year (in metric 
    tons)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       
20a Of the amount listed on line 20, what amount was carbon dioxide? . . . . . . . . . . .                         
20b Of the amount listed on line 20, what amount was carbon monoxide?                     . . . . . . . . .        
21  Was annualization of first-year captured carbon oxide required for this calendar year?                      . . . . . . . . . . . . . . . . . . . . . . . . . . .
21a If you answered “Yes” to line 21, state the annualized carbon oxide emissions . . . .                          
Section 3—Information about carbon oxide sequestration credit and your elections:
22  During the calendar year, are other parties contractually ensuring disposal, injection, or utilization of qualified carbon oxide captured 
    at this facility? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23  For this calendar year, do you elect to allow any of the parties described on line 22 to claim some or all of the credit?                         . . . . . . . .
24  If you answered “No” to line 14, do you elect to apply the $10 and $20 rates (adjusted for inflation) in lieu of the applicable dollar 
    amounts?   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
25  If you answered “Yes” to line 24, determine the credit using lines 1 through 6 in Part III.
26  If you answered “No” to line 24, determine the credit using lines 7 through 15 in Part III.
27  Is the facility described in Part I an applicable facility and are you making the election under section 45Q(f)(6)? See 
    instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27a If you answered “Yes” to both parts of line 27, determine the credit using lines 7, 8, or 9 in Part III. See instructions.
Part II. Reserved for future use.
Part III. Credit Calculation
Section A—Facilities at Which Qualified Carbon Oxide Qualifies for a Credit Under Section 45Q(a)(1) or (2) for Which an Election Was 
Made Under Section 45Q(b)(3)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9, 2018, and 
before 2023, disposed of in secure geological storage, and not used as a tertiary injectant in a qualified enhanced oil or natural gas recovery project, 
nor utilized as described in section 45Q(f)(5). 
                                                                                                                                                                (c) Carbon oxide 
                                                                                                                                                                  sequestration 
                                                                                                                      (a) Metric tons           (b) Rate          credit. Multiply 
                                                                                                                                                                  column (a) by 
                                                                                                                                                                    column (b).
1a  Metric tons captured and measured at the point of disposal                . . . . . . . . . . . . . . .
1b  Metric tons captured and securely stored by you. Attach Model Certificates 
    DISP-Operator and DISP-Owner for each disposal site                 . . . . . . . . . . . . . . . . . .
1c  Metric tons captured and securely stored (physically disposed) by another person. 
    Attach Model Certificates DISP-Operator and DISP-Owner for each disposal site . .
1d  Add lines 1b and 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                         $26.94
1e  Metric tons captured and securely stored (physically disposed) by another person and 
    for which you allow that person to claim the resulting carbon oxide sequestration credit.                                                   $26.94
    Attach Model Certificate ELECT for each disposal site               . . . . . . . . . . . . . . . . . .
1f  Your carbon oxide sequestration credit. Subtract line 1e from line 1d . . . . . . . . . .                                                   $26.94
                                                                                                                                                                Model Certificate CF

14                                                                                                                      Instructions for Form 8933 (Rev. 12-2023)

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                                                                                                                                  Page 3
Section A—Facilities at Which Qualified Carbon Oxide Qualifies for a Credit Under Section 45Q(a)(1) or (2) for Which an Election Was 
Made Under Section 45Q(b)(3) (continued)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9, 2018, and 
before 2023, disposed of in secure geological storage, and used as a tertiary injectant in a qualified enhanced oil or natural gas recovery project.
                                                                                                                               (c) Carbon oxide 
                                                                                                                               sequestration credit. 
                                                                                                       (a) Metric tons (b) Rate
                                                                                                                               Multiply column (a) 
                                                                                                                               by column (b).
2a Metric tons captured and measured at the point of injection         . . . . . . . . . . . . . . .
2b Metric tons captured and injected by you. Attach Model Certificates EOR-Operator and 
   EOR-Owner for each recovery project . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2c Metric tons captured and injected by another person. Attach Model Certificates 
   EOR-Operator and EOR-Owner for each recovery project              . . . . . . . . . . . . . . . .
2d Add lines 2b and 2c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                 $13.47
2e Metric tons captured and injected by another person and for which you allow that 
   person to claim the resulting carbon oxide sequestration credit. Attach Model                                       $13.47
   Certificate ELECT for each recovery project     . . . . . . . . . . . . . . . . . . . . . . . . .
2f Your carbon oxide sequestration credit. Subtract line 2e from line 2d . . . . . . . . . .                           $13.47
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9, 2018, and 
before 2023, and utilized as described in section 45Q(f)(5). 
                                                                                                                               (c) Carbon oxide 
                                                                                                                               sequestration credit. 
                                                                                                       (a) Metric tons (b) Rate
                                                                                                                               Multiply column (a) 
                                                                                                                               by column (b).
3a Metric tons captured and measured at the point of utilization . . . . . . . . . . . . . . .
3b Metric tons captured and physically utilized by you. Attach Model Certificate UTZ for 
   each utilization facility. Expressed as carbon dioxide equivalents that were determined 
   pursuant to an approved Life Cycle Assessment (LCA). See instructions               . . . . . . .
3c Metric tons captured and physically utilized by another person. Attach Model 
   Certificate UTZ for each utilization facility. Expressed as carbon dioxide equivalents 
   that were determined pursuant to an approved LCA. See instructions              . . . . . . . . .
3d Add lines 3b and 3c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                 $13.47
3e Metric tons captured and physically utilized by another person and for which you elect 
   to allow that person to claim the resulting carbon oxide sequestration credit. Expressed 
                                                                                                                       $13.47
   as carbon dioxide equivalents that were determined pursuant to an approved LCA. See 
   instructions. Attach Model Certificate ELECT for each utilization facility        . . . . . . . .
3f Your carbon oxide sequestration credit. Subtract line 3e from line 3d . . . . . . . . . .                           $13.47
                                                                                                                               Model Certificate CF

Instructions for Form 8933 (Rev. 12-2023)                                                                                                             15

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                                                                                                                                    Page 4
Section A—Facilities at Which Qualified Carbon Oxide Qualifies for a Credit Under Section 45Q(a)(1) or (2) for Which an Election Was 
Made Under Section 45Q(b)(3) (continued)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility after 2022, disposed of in secure 
geological storage, and not used as a tertiary injectant in a qualified enhanced oil or natural gas recovery project, nor utilized as described in section 
45Q(f)(5). 
                                                                                                                                 (c) Carbon oxide 
                                                                                                                                 sequestration credit. 
                                                                                                        (a) Metric tons  (b) Rate
                                                                                                                                 Multiply column (a) 
                                                                                                                                 by column (b).
4a  Metric tons captured and measured at the point of disposal          . . . . . . . . . . . . . . .
4b  Metric tons captured and securely stored (physically disposed) by you. Attach Model 
    Certificates DISP-Operator and DISP-Owner for each disposal site            . . . . . . . . . . .
4c  Metric tons captured and securely stored (physically disposed) by another person. 
    Attach Model Certificates DISP-Operator and DISP-Owner for each disposal site . .
4d  Add lines 4b and 4c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $134.70
4e  Metric tons captured and securely stored (physically disposed) by another person and 
    for which you allow that person to claim the resulting carbon oxide sequestration credit.                            $134.70
    Attach Model Certificate ELECT for each disposal site       . . . . . . . . . . . . . . . . . . .
4f  Your carbon oxide sequestration credit. Subtract line 4e from line 4d . . . . . . . . . .                            $134.70
Note. Enter $26.94 in column (b) for lines 4d, 4e, and 4f if prevailing wage and apprenticeship requirements aren't met. 
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility after 2022, disposed of in secure 
geological storage, and used as a tertiary injectant in a qualified enhanced oil or natural gas recovery project. 
                                                                                                                                 (c) Carbon oxide 
                                                                                                                                 sequestration credit. 
                                                                                                        (a) Metric tons  (b) Rate
                                                                                                                                 Multiply column (a) 
                                                                                                                                 by column (b).
5a  Metric tons captured and measured at the point of injection         . . . . . . . . . . . . . . .
5b  Metric tons captured and injected by you. Attach Model Certificates EOR-Operator and 
    EOR-Owner for each recovery project . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5c  Metric tons captured and injected by another person. Attach Model Certificates 
    EOR-Operator and EOR-Owner for each recovery project              . . . . . . . . . . . . . . . .
5d  Add lines 5b and 5c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $67.35 
5e  Metric tons captured and injected by another person and for which you allow that 
    person to claim the resulting carbon oxide sequestration credit. Attach Model                                        $67.35 
    Certificate ELECT for each recovery project     . . . . . . . . . . . . . . . . . . . . . . . . .
5f  Your carbon oxide sequestration credit. Subtract line 5e from line 5d . . . . . . . . . .                            $67.35 
Note. Enter $13.47 in column (b) for lines 5d, 5e, and 5f if prevailing wage and apprenticeship requirements aren't met. 
                                                                                                                                 Model Certificate CF

16                                                                                                      Instructions for Form 8933 (Rev. 12-2023)

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                                                                                                                                                Page 5
Section A—Facilities at Which Qualified Carbon Oxide Qualifies for a Credit Under Section 45Q(a)(1) or (2) for Which an Election Was 
Made Under Section 45Q(b)(3) (continued)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility after 2022, and utilized as 
described in section 45Q(f)(5). 
                                                                                                                                 (c) Carbon oxide 
                                                                                                                                 sequestration credit. 
                                                                                                        (a) Metric tons  (b) Rate
                                                                                                                                 Multiply column (a) 
                                                                                                                                 by column (b).
6a  Metric tons captured and measured at the point of utilization . . . . . . . . . . . . . . .
6b  Metric tons captured and physically utilized by you. Attach Model Certificate UTZ for 
    each utilization facility. Expressed as carbon dioxide equivalents that were determined 
    pursuant to an approved Life Cycle Assessment (LCA). See instructions               . . . . . . .
6c  Metric tons captured and physically utilized by another person. Attach Model 
    Certificate UTZ for each utilization facility. Expressed as carbon dioxide equivalents 
    that were determined pursuant to an approved LCA. See instructions              . . . . . . . . .
6d  Add lines 6b and 6c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $67.35
6e  Metric tons captured and physically utilized by another person and for which you elect 
    to allow that person to claim the resulting carbon oxide sequestration credit. Expressed 
                                                                                                                         $67.35
    as carbon dioxide equivalents that were determined pursuant to an approved LCA. See 
    instructions. Attach Model Certificate ELECT for each utilization facility        . . . . . . . .
6f  Your carbon oxide sequestration credit. Subtract line 6e from line 6d . . . . . . . . . .                            $67.35
Note. Enter $13.47 in column (b) for lines 6d, 6e, and 6f if prevailing wage and apprenticeship requirements aren't met. 
Section B—Qualified Facilities Under Section 45Q(a)(3) or (4) for Which No Election Was Made Under Section 45Q(b)(3)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9, 2018, and 
before 2023, during the 12-year period beginning on the date the equipment was originally placed in service, disposed of in secure geological 
storage, and not used as a tertiary injectant in a qualified enhanced oil or natural gas recovery project, nor utilized as described in section 45Q(f)(5).
                                                                                                                                 (c) Carbon oxide 
                                                                                                                                 sequestration credit. 
                                                                                                        (a) Metric tons  (b) Rate
                                                                                                                                 Multiply column (a) 
                                                                                                                                 by column (b).
7a  Metric tons captured and measured at the point of disposal          . . . . . . . . . . . . . . .
7b  Metric tons captured and securely stored (physically disposed) by you. Attach Model 
    Certificates DISP-Operator and DISP-Owner for each disposal site            . . . . . . . . . . .
7c  Metric tons captured and securely stored (physically disposed) by another person. 
    Attach Model Certificates DISP-Operator and DISP-Owner for each disposal site . .
7d  Add lines 7b and 7c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $40.89
7e  Metric tons captured and securely stored (physically disposed) by another person and 
    for which you allow that person to claim the resulting carbon oxide sequestration credit.                            $40.89
    Attach Model Certificate ELECT for each disposal site       . . . . . . . . . . . . . . . . . . .
7f  Your carbon oxide sequestration credit. Subtract line 7e from line 7d . . . . . . . . . .                            $40.89
                                                                                                                                 Model Certificate CF

Instructions for Form 8933 (Rev. 12-2023)                                                                                                             17

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                                                                                                                                              Page 6
Section B—Qualified Facilities Under Section 45Q(a)(3) or (4) for Which No Election Was Made Under Section 45Q(b)(3) (continued)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9, 2018, and 
before 2023, during the 12-year period beginning on the date the equipment was originally placed in service, disposed of in secure geological 
storage, and used as a tertiary injectant in a qualified enhanced oil or natural gas recovery project.
                                                                                                                                  (c) Carbon oxide 
                                                                                                                                  sequestration credit. 
                                                                                                          (a) Metric tons (b) Rate
                                                                                                                                  Multiply column (a) 
                                                                                                                                  by column (b).
8a Metric tons captured and measured at the point of injection             . . . . . . . . . . . . . . .
8b Metric tons captured and injected by you. Attach Model Certificates EOR-Operator 
   and EOR-Owner for each recovery project . . . . . . . . . . . . . . . . . . . . . . . . . .
8c Metric tons captured and injected by another person. Attach Model Certificates 
   EOR-Operator and EOR-Owner for each recovery project                  . . . . . . . . . . . . . . . .
8d Add lines 8b and 8c .   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $27.61
8e Metric tons captured and injected by another person and for which you allow that                                       $27.61
   person to claim the resulting carbon oxide sequestration credit. Attach Model 
   Certificate ELECT for each recovery project         . . . . . . . . . . . . . . . . . . . . . . . . .
8f Your carbon oxide sequestration credit. Subtract line 8e from line 8d . . . . . . . . . .                              $27.61
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9, 2018, and 
before 2023, during the 12-year period beginning on the date the equipment was originally placed in service, and utilized as described in section 
45Q(f)(5).
                                                                                                                                  (c) Carbon oxide 
                                                                                                                                  sequestration credit. 
                                                                                                          (a) Metric tons (b) Rate
                                                                                                                                  Multiply column (a) 
                                                                                                                                  by column (b).
9a Metric tons captured and measured at the point of utilization . . . . . . . . . . . . . . .
9b Metric tons captured and physically utilized by you. Attach Model Certificate UTZ for 
   each utilization facility. Expressed as carbon dioxide equivalents that were determined 
   pursuant to an approved Life Cycle Assessment (LCA). See instructions                   . . . . . . .
9c Metric tons captured and physically utilized by another person. Attach Model 
   Certificate UTZ for each utilization facility. Expressed as carbon dioxide equivalents 
   that were determined pursuant to an approved LCA. See instructions                  . . . . . . . . .
9d Add lines 9b and 9c   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $27.61
9e Metric tons captured and physically utilized by another person and for which you elect 
   to allow that person to claim the resulting carbon oxide sequestration credit. 
   Expressed as carbon dioxide equivalents that were determined pursuant to an                                            $27.61
   approved LCA. See instructions. Attach Model Certificate ELECT for each utilization 
   project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9f Your carbon oxide sequestration credit. Subtract line 9e from line 9d . . . . . . . . . .                              $27.61
                                                                                                                                  Model Certificate CF

18                                                                                                        Instructions for Form 8933 (Rev. 12-2023)

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                                                                                                                                              Page 7
Section B—Qualified Facilities Under Section 45Q(a)(3) or (4) for Which No Election Was Made Under Section 45Q(b)(3) (continued)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility after 2022, during the 12-year 
period beginning on the date the equipment was originally placed in service, disposed of in secure geological storage, and not used as a tertiary 
injectant in a qualified enhanced oil or natural gas recovery project, nor utilized as described in section 45Q(f)(5).
                                                                                                                                (c) Carbon oxide 
                                                                                                                                sequestration credit. 
                                                                                                       (a) Metric tons  (b) Rate
                                                                                                                                Multiply column (a) 
                                                                                                                                by column (b).
10a Metric tons captured and measured at the point of disposal         . . . . . . . . . . . . . . .
10b Metric tons captured and securely stored (physically disposed) by you. Attach Model 
    Certificates DISP-Operator and DISP-Owner for each disposal site. . . . . . . . . . .
10c Metric tons captured and securely stored (physically disposed) by another person. 
    Attach Model Certificates DISP-Operator and DISP-Owner for each disposal site . .
10d Add lines 10b and 10c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $85
10e Metric tons captured and securely stored (physically disposed) by another person and 
    for which you allow that person to claim the resulting carbon oxide sequestration.                                  $85
    Attach Model Certificate ELECT for each disposal site      . . . . . . . . . . . . . . . . . . .
10f Your carbon oxide sequestration credit. Subtract line 10e from line 10d          . . . . . . . .                    $85
Note. Enter $17 in column (b) for lines 10d, 10e, and 10f if prevailing wage and apprenticeship requirements aren't met.
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility after 2022, during the 12-year 
period beginning on the date the equipment was originally placed in service, disposed of in secure geological storage, and used as a tertiary 
injectant in a qualified enhanced oil or natural gas recovery project.
                                                                                                                                (c) Carbon oxide 
                                                                                                                                sequestration credit. 
                                                                                                       (a) Metric tons  (b) Rate
                                                                                                                                Multiply column (a) 
                                                                                                                                by column (b).
11a Metric tons captured and measured at the point of injection        . . . . . . . . . . . . . . .
11b Metric tons captured and injected by you. Attach Model Certificates EOR-Operator 
    and EOR-Owner for each recovery project . . . . . . . . . . . . . . . . . . . . . . . . . .
11c Metric tons captured and injected by another person. Attach Model Certificates 
    EOR-Operator and EOR-Owner for each recovery project             . . . . . . . . . . . . . . . .
11d Add lines 11b and 11c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $60
11e Metric tons captured and injected by another person and for which you allow that 
    person to claim the resulting carbon oxide sequestration credit. Attach Model                                       $60
    Certificate ELECT for each recovery project    . . . . . . . . . . . . . . . . . . . . . . . . .
11f Your carbon oxide sequestration credit. Subtract line 11e from line 11d          . . . . . . . .                    $60
Note. Enter $12 in column (b) for lines 11d, 11e, and 11f if prevailing wage and apprenticeship requirements aren't met.
                                                                                                                                Model Certificate CF

Instructions for Form 8933 (Rev. 12-2023)                                                                                                          19

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                                                                                                                                      Page 8
Section B—Qualified Facilities Under Section 45Q(a)(3) or (4) for Which No Election Was Made Under Section 45Q(b)(3) (continued)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility after 2022, during the 12-year 
period beginning on the date the equipment was originally placed in service, and utilized as described in section 45Q(f)(5).
                                                                                                                                   (c) Carbon oxide 
                                                                                                                                   sequestration credit. 
                                                                                                           (a) Metric tons (b) Rate
                                                                                                                                   Multiply column (a) 
                                                                                                                                   by column (b).
12a Metric tons captured and measured at the point of utilization . . . . . . . . . . . . . . .
12b Metric tons captured and physically utilized by you. Attach Model Certificate UTZ for 
    each utilization facility. Expressed as carbon dioxide equivalents that were determined 
    pursuant to an approved Life Cycle Assessment (LCA). See instructions                   . . . . . . .
12c Metric tons captured and physically utilized by another person. Attach Model 
    Certificate UTZ for each utilization facility. Expressed as carbon dioxide equivalents 
    that were determined pursuant to an approved LCA. See instructions                  . . . . . . . . .
12d Add lines 12b and 12c   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $60
12e Metric tons captured and physically utilized by another person and for which you elect 
    to allow that person to claim the resulting carbon oxide sequestration credit. 
    Expressed as carbon dioxide equivalents that were determined pursuant to an                                            $60
    approved LCA. See instructions. Attach Model Certificate ELECT for each utilization 
    project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12f Your carbon oxide sequestration credit. Subtract line 12e from line 12d               . . . . . . . .                  $60
Note. Enter $12 in column (b) for lines 12d, 12e, and 12f if prevailing wage and apprenticeship requirements aren't met.
Section C—Qualified DAC Facilities Under Section 45Q(d) Placed in Service After 2022
Qualified carbon oxide captured using DAC equipment originally placed in service at a qualified DAC facility after 2022, during the 12-year period 
beginning on the date the equipment was originally placed in service, disposed of in secure geological storage, and not used as a tertiary injectant in 
a qualified enhanced oil or natural gas recovery project, nor utilized as described in section 45Q(f)(5).
                                                                                                                                   (c) Carbon oxide 
                                                                                                                                   sequestration credit. 
                                                                                                           (a) Metric tons (b) Rate
                                                                                                                                   Multiply column (a) 
                                                                                                                                   by column (b).
13a Metric tons captured and measured at the point of disposal              . . . . . . . . . . . . . . .
13b Metric tons captured and securely stored (physically disposed) by you. Attach Model 
    Certificates DISP-Operator and DISP-Owner for each disposal site                . . . . . . . . . . .
13c Metric tons captured and securely stored (physically disposed) by another person. 
    Attach Model Certificates DISP-Operator and DISP-Owner for each disposal site . .
13d Sum of 13b and 13c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                     $180
13e Metric tons captured and securely stored (physically disposed) by another person and 
    for which you allow that person to claim the resulting carbon oxide sequestration                                      $180
    credit. Attach Model Certificate ELECT for each disposal site             . . . . . . . . . . . . . .
13f Your carbon oxide sequestration credit. Subtract line 13e from line 13d               . . . . . . . .                  $180
Note. Enter $36 in column (b) for lines 13d, 13e, and 13f if prevailing wage and apprenticeship requirements aren't met.
                                                                                                                                   Model Certificate CF

20                                                                                                         Instructions for Form 8933 (Rev. 12-2023)

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                                                                                                                                      Page 9
Section C—Qualified DAC Facilities Under Section 45Q(d) Placed in Service After 2022 (continued)
Qualified carbon oxide captured using DAC equipment originally placed in service at a qualified DAC facility after 2022, during the 12-year period 
beginning on the date the equipment was originally placed in service, disposed of in secure geological storage, and used as a tertiary injectant in a 
qualified enhanced oil or natural gas recovery project.
                                                                                                                                   (c) Carbon oxide 
                                                                                                                                   sequestration credit. 
                                                                                                           (a) Metric tons (b) Rate
                                                                                                                                   Multiply column (a) 
                                                                                                                                   by column (b).
14a Metric tons captured and measured at the point of injection             . . . . . . . . . . . . . . .
14b Metric tons captured and injected by you. Attach Model Certificates EOR-Operator 
    and EOR-Owner for each recovery project . . . . . . . . . . . . . . . . . . . . . . . . . .
14c Metric tons captured and injected by another person. Attach Model Certificates 
    EOR-Operator and EOR-Owner for each recovery project                  . . . . . . . . . . . . . . . .
14d Add lines 14b and 14c   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $130
14e Metric tons captured and injected by another person and for which you allow that 
    person to claim the resulting carbon oxide sequestration credit. Attach Model                                          $130
    Certificate ELECT for each recovery project         . . . . . . . . . . . . . . . . . . . . . . . . .
14f Your carbon oxide sequestration credit. Subtract line 14e from line 14d               . . . . . . . .                  $130
Note. Enter $26 in column (b) for lines 14d, 14e, and 14f if prevailing wage and apprenticeship requirements aren't met.
Qualified carbon oxide captured using DAC equipment originally placed in service at a qualified DAC facility after 2022, during the 12-year period 
beginning on the date the equipment was originally placed in service, and utilized as described in section 45Q(f)(5).
                                                                                                                                   (c) Carbon oxide 
                                                                                                                                   sequestration credit. 
                                                                                                           (a) Metric tons (b) Rate
                                                                                                                                   Multiply column (a) 
                                                                                                                                   by column (b).
15a Metric tons captured and measured at the point of utilization . . . . . . . . . . . . . . .
15b Metric tons captured and physically utilized by you. Attach Model Certificate UTZ for 
    each utilization facility. Expressed as carbon dioxide equivalents that were determined 
    pursuant to an approved Life Cycle Assessment (LCA). See instructions                   . . . . . . .
15c Metric tons captured and physically utilized by another person. Attach Model 
    Certificate UTZ for each utilization facility. Expressed as carbon dioxide equivalents 
    that were determined pursuant to an approved LCA. See instructions                  . . . . . . . . .
15d Sum of 15b and 15c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                     $130
15e Metric tons captured and physically utilized by another person and for which you elect 
    to allow that person to claim the resulting carbon oxide sequestration credit. 
    Expressed as carbon dioxide equivalents that were determined pursuant to an                                            $130
    approved LCA. See instructions. Attach Model Certificate ELECT for each utilization 
    project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15f Your carbon oxide sequestration credit. Subtract line 15e from line 15d               . . . . . . . .                  $130
Note. Enter $26 in column (b) for lines 15d, 15e, and 15f if prevailing wage and apprenticeship requirements aren't met.
                                                                                                                                   Model Certificate CF

Instructions for Form 8933 (Rev. 12-2023)                                                                                                           21

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                                                                                                                         Page 10
                                                   Capture Facility Certification (continued)
Under penalties of perjury, I attest that I am an officer of the company that’s the owner of the subject capture facility. I further attest that the above 
information is true and correct. 

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN

                                                                                             Model Certificate CF

22                                                                                           Instructions for Form 8933 (Rev. 12-2023)

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Model Certificate DISP-Operator

Disposal Operator Certification 2023
Name(s) shown on return: Identifying number:
Information about the owners of the geologic disposal site:
1 In Table 1 below, list information about each owner of the disposal site during the calendar year. If there’re more than four owners, prepare a
separate table with all the owner information and attach it to this model certificate.
If one or more of the owners is a partnership or S corporation, provide information for the pass-through entity, not partners or shareholders.
If one or more of the owners is part of a joint venture that has elected out of subchapter K of the Code, provide information for all such owners.
Table 1 — Information About the Owner(s) of the Disposal Site
Disposal site Operating
Name Address EIN
owner interest (%)
1
2
3
4
Information about the geologic disposal site:
2 Name and location (county and state, or offshore tract) . . . . . . . . . . . . . . . . . . .
3 List the name and EIN of the operator of the site . . . . . . . . . . . . . . . . . . . . . . .
4 List any other companies that are identified as the operator of the project for any other
purpose(s) and the nature of the purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5a IRS-issued registration number(s) for the geologic disposal facility . . . . . . . . . . . .
5b Geologic disposal site’s EPA e-GGRT ID number(s)* . . . . . . . . . . . . . . . . . . . . .
6 When did injection of captured qualified carbon oxide begin (MM/YYYY)? . . . . . . .
7 Check here to declare that all figures of stored carbon oxide on this certificate are for carbon oxide consistent with figures reported to the
EPA pursuant to the applicable MRV plan and subpart RR of the EPA's Greenhouse Gas Reporting Program . . . . . . . . . . . . . . . .
8 Attach a copy of the approved MRV plan or provide the URL where it can be viewed on the EPA website.
Information about the qualified carbon oxide supplied to the geologic disposal site and securely stored:
9 In Table 2, 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. For qualified carbon oxide, “supplier”
means the person who captured the qualified carbon oxide, which may differ from the company that sold the qualified carbon oxide or
physically delivered the qualified carbon oxide to the owner of the geologic disposal site.
Table 2 — Information About Suppliers of Qualified Carbon Oxide
Check if supplier
Name and location IRS-issued supplied any
Qualified carbon EPA's
Name EIN of capture facility registration nonqualified
oxide supplier e-GGRT ID*
(county, state) number carbon oxide
from any source
1
2
3
* If available.
Model Certificate DISP-Operator

Instructions for Form 8933 (Rev. 12-2023) 23

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Page 2
Disposal Operator Certification (continued)
10 Complete Table 3 below using information that’s consistent with all applicable EPA filings. If there’re more than four owners of the geologic
disposal site or suppliers of qualified carbon oxide, prepare a separate table with all the supplier information and attach it to this model
certificate.
11 Check here to attest that all figures in Table 3 conform to all applicable EPA filings . . . . . . . . . . . . . . . . . . . . . . . . . . .
Table 3 — Information About Disposal
Qualified carbon Qualified carbon Qualified carbon Total qualified All other suppliers Total metric tons for all
oxide supplier oxide supplier oxide supplier carbon oxide from all of nonqualified carbon oxide suppliers
number 1 number 2 number 3 suppliers carbon oxide
(H)
(I) Metric
Metric (L) Metric
tons (M) Metric
(A) (B) (C) (D) (E) (F) (G) tons (K) tons
stored (J) Metric tons stored
Geologic Metric Metric Metric Metric Metric Metric delivered Metric delivered
(add tons (add
disposal tons tons tons tons tons tons (add tons (add
columns delivered columns (I)
site owner delivered stored delivered stored delivered stored columns stored columns
(C), (E), and (K))
(B), (D), (H) and (J))
and (G))
and (F))
1
2
3
4
5 Total
(add lines
1 through
4)

Under penalties of perjury, I attest that I am an officer of the company that’s the operator of the subject geologic disposal site or that I have been
designated by the operating interest owners to prepare and submit this certificate to the IRS on their behalf. I further attest that the above information
is true and correct.

Signature and date signed

Printed or typed name of person signing this report

Title

Company’s name and EIN

Model Certificate DISP-Operator

24 Instructions for Form 8933 (Rev. 12-2023)

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                                                               Model Certificate DISP-Owner

                                                                     Disposal Owner Certification                                                             2023
Name(s) shown on return:                                                                                                         Identifying number: 
Information about you, the owner of the geologic disposal site:
1    Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
2    Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
3    EIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Information about your suppliers of qualified carbon oxide. Complete a separate Model Certificate DISP-Owner for each of your 
suppliers of qualified carbon oxide:
4    Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
5    EIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
6    Name and location of facility (if supplier supplied any qualified carbon oxide)               . . . . . . . . . . . . .    
7    Type of industrial facility at which the supplier captured its qualified carbon oxide . . . . . . . . . . .                
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 the EIN of the entity that’s an owner of the geologic disposal site. 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                        Yes No
     will securely store the qualified carbon oxide in the manner required under section 45Q and the underlying regulations?                           . . .
10   Provide the date (MM/DD/YYYY) of the contract referenced in the line above or the date of the most 
     recent amendment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       
11   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 in Model 
     Certificate DISP-Operator, Table 3)       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
12   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 in Model Certificate DISP-Operator, Table 3) . . . . . . . . . . . . . . . . . . .                
13   Metric tons of nonqualified carbon oxide received by you during the calendar year                   . . . . . . . . . .    
14   Metric tons of nonqualified carbon oxide stored by you during the calendar year (metric tons should 
     be from Model Certificate DISP-Operator, Table 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              
15   Add lines 11 and 13. Total amount of qualified carbon oxide injected (amount should agree with the 
     figure reported for you in Model Certificate DISP-Operator, Table 3)              . . . . . . . . . . . . . . . . . . .    
16   Add lines 12 and 14. Total amount of qualified carbon oxide stored (amount should agree with the 
     figure for you in Model Certificate DISP-Operator, Table 3) . . . . . . . . . . . . . . . . . . . . . . . . .              
17   Reserved for future use.
18   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 a copy of Model Certificate 
     ELECT signed by the supplier for this calendar year           . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under penalties of perjury, I attest that I am an officer of the company that’s the owner of the subject DISP project. I further attest that the above 
information is true and correct and that I have provided a signed copy of this completed certificate to each person who supplied qualified carbon 
oxide to my company for use at the subject DISP project during this calendar year.

Signature and date signed

Printed or typed name of person signing this report 

Title

Company's name and EIN

                                                                                                                                                   Model Certificate DISP-Owner

Instructions for Form 8933 (Rev. 12-2023)                                                                                                                         25

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                                                         Model Certificate EOR-Operator

                                           Enhanced Oil Recovery Operator Certification                                                                     2023
Name(s) shown on return:                                                                                                         Identifying number:
Information about the owners of the EOR project:
1  In Table 1 below, list information about each owner of the EOR project during the calendar year. If there’re more than four owners, prepare a 
   separate table with all the owner information and attach it to this model certificate. 
   If one or more of the owners is a partnership or S corporation, provide information for the pass-through entity, not partners or shareholders.
   If one or more of the owners is part of a joint venture that has elected out of subchapter K of the Code, provide the information for all such 
   owners. 
   Table 1 — Information About the Owner(s) of the EOR Project
   EOR project                         Name                                            Address                                   EIN                     Operating 
               owner                                                                                                                                     interest (%)
               1
               2
               3
               4

Information about the EOR project: 
2  Name and location (county and state) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         
3  List the name and EIN of the person who, for purposes of Regulations section 1.45Q-2(h), is 
   the operator of the project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
4  List any other companies that are identified as the operator of the project for any other 
   purpose(s) and the nature of the purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         
5a IRS-issued registration number(s) for the EOR project . . . . . . . . . . . . . . . . . . . . . . . . .            
5b EPA e-GGRT ID number(s)* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         
6  Date (MM/YYYY) on which the injection of captured qualified carbon oxide began                    . . . . . . .    
7  If the project was previously certified under section 43, state the name of the certified project 
   and date (MM/DD/YYYY) of the petroleum engineer's certification               . . . . . . . . . . . . . . . . .    
8  If the project wasn’t previously certified under section 43, attach a copy of a valid petroleum engineer's certification to this Model Certificate 
   EOR-Operator.
                                                                                                                                                            Yes      No
9  Is this project an enhanced natural gas recovery project? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10 Are all injection wells appropriately permitted? See Secure geological storage, earlier . . . . . . . . . . . . . . . . . . . . . . . . . .
11 If you answered “No” to line 10, the credit can’t be claimed. 
12 Are any of the wells in the project EPA Class VI?       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13 If you answered “Yes” to line 12, check here to declare that all figures of stored qualified carbon oxide on this model 
   certificate are consistent with figures reported to the EPA pursuant to the applicable MRV plan and subpart RR of 
   EPA’s Greenhouse Gas Reporting Program            . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14 If you answered “Yes” to line 12, provide the EPA approval date (MM/DD/YYYY) of the MRV 
   plan, and attach a copy of the approved MRV plan or its URL on the EPA's website . . . . . . .                     
15 If you answered “Yes” to line 10 and “No” to line 12, are you relying on subpart RR of the 
   Greenhouse Gas Reporting Program or ISO 27916 to demonstrate secure storage (check 
   which one)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          Subpart RR                    ISO 27916
16 If line 15 is subpart RR, provide the EPA approval date (MM/DD/YYYY) of the MRV plan, and 
   attach a copy of the approved MRV plan or its URL on the EPA's website . . . . . . . . . . . . .                   
17 If line 15 is ISO 27916, attach a copy of the ISO 27916 documentation for the year.
18 If line 15 is ISO 27916, attach a copy of the certification completed by a qualified independent engineer or geologist.
Information about the qualified carbon oxide supplied to the EOR project and securely stored: 
19 In Table 2, 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 45Q facilities. For qualified carbon oxide, “supplier” means 
   the person who captured the qualified carbon oxide, who may differ from the company that sold the carbon oxide or physically delivered the 
   carbon oxide to the owner of the EOR utilization facility.
* If available.
                                                                                                                                            Model Certificate EOR-Operator

26                                                                                                                 Instructions for Form 8933 (Rev. 12-2023)

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                                                                                                                                              Page 2
                                        Enhanced Oil Recovery Operator Certification (continued)
     Table 2 — Information About Suppliers of Qualified Carbon Oxide
                                                                                                                                         Check if 
                                                                                                                                         supplier 
        Qualified                                                                    Location of capture               Check if supplier 
                                                                         Name of                                                         provided 
     carbon oxide             Name                          EIN                                     facility provided any qualified 
                                                                   capture facility                                                      any 
        supplier                                                                      (county, state)                  carbon oxide
                                                                                                                                         nonqualified 
                                                                                                                                         carbon oxide
        1
        2
        3
20   Complete Table 3 below using information that conforms to all applicable EPA filings and certified ISO 27916 documentation if it was used to 
     demonstrate secure storage. If there’re more than four owners of the EOR project or three suppliers of qualified carbon oxide, prepare a 
     separate table that includes all relevant information and attach it to this model certificate. 
21   Check here to attest that all figures in Table 3 conform to all applicable EPA filings and certified ISO 27916 documentation . .
     Table 3 — Information About Enhanced Oil Recovery
                  Qualified carbon      Qualified carbon  Qualified carbon Total qualified                   All other Total metric tons for all 
                         oxide supplier oxide supplier      oxide supplier carbon oxide from        suppliers of       carbon oxide suppliers
                         number 1                  number 2     number 3   all suppliers            nonqualified 
                                                                                                    carbon oxide
                                                                                     (I) 
                                                                           (H) 
                                                                                     Metric 
                                                                           Metric 
                                                                                     tons                              (L) Metric        (M) Metric 
                         (B)  (C)       (D)        (E)      (F)    (G)     tons                     (J)      (K) 
        (A) EOR                                                                      stored                            tons              tons stored 
                  Metric      Metric    Metric     Metric   Metric Metric delivered                 Metric   Metric 
        project                                                                      (add                              delivered         (add 
                         tons tons      tons       tons     tons    tons    (add                    tons     tons 
        owner                                                                        columns                           (add columns  columns (I) 
                  delivered stored delivered stored delivered stored columns                        delivered stored
                                                                                      (C),                             (H) and (J))      and (K))
                                                                           (B), (D), 
                                                                                     (E), and 
                                                                           and (F))
                                                                                     (G))
     1
     2
     3
     4
     5 Total (add 
        lines 1 
        through 4)
Under penalties of perjury, I attest that I am an officer of the company that’s the operator of the subject EOR project or that I have been designated 
by the operating interest owners to prepare and submit this certificate to the IRS on their behalf. I further attest that the above information is true and 
correct.

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN

                                                                                                                       Model Certificate EOR-Operator

Instructions for Form 8933 (Rev. 12-2023)                                                                                                              27

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                                                             Model Certificate EOR-Owner

                                                         Enhanced Oil Recovery Owner Certification                                                          2023
Name(s) shown on return:                                                                                                  Identifying number: 
Information about you, the owner of the EOR project:
1    Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     
2    Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      
3    EIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
Information about all suppliers of qualified carbon oxide to you. Complete multiple model certificates if you had more than one supplier 
of qualified carbon oxide:
4    Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     
5    EIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
6    Name and location (county, state) of qualified carbon oxide capture facility . . . . . . . . . . .                   
7    Type of industrial facility at which the supplier captured its qualified carbon oxide . . . . . . .                  
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 the EIN of the entity that’s an owner of the geologic disposal site. 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                          Yes No
     you will securely store the qualified carbon oxide in the manner required under section 45Q and the underlying regulations?
10   Provide the date (MM/DD/YYYY) of the contract referenced in the line above or the date of the 
     most recent amendment       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      
11   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 in Model Certificate EOR-Operator, Table 3)            . . . . . . . . . . . . . . . . . . . . . . . .      
12   Metric tons of qualified carbon oxide stored by you during the year (metric tons should agree 
     with the figure reported for you for this supplier by the disposal site's operator in Model 
     Certificate EOR-Operator, Table 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           
13   Metric tons of nonqualified carbon oxide received by you during the year . . . . . . . . . . . .                     
14   Metric tons of nonqualified carbon oxide utilized as a tertiary injectant stored by you during the 
     calendar year (metric tons should be from Model Certificate EOR-Operator, Table 3)                    . . . . .      
15   Add lines 11 and 13. Total amount of qualified carbon oxide injected (amount should agree with 
     the figure for you in Model Certificate EOR-Operator, Table 3) . . . . . . . . . . . . . . . . . . .                 
16   Add lines 12 and 14. Total amount of qualified carbon oxide stored (amount should agree with 
     the figure for you in Model Certificate EOR-Operator, Table 3) . . . . . . . . . . . . . . . . . . .                 
17   Reserved for future use.
18   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 a copy of Model Certificate 
     ELECT signed by both you and the supplier for this calendar year              . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under penalties of perjury, I attest that I am an officer of the company that’s the owner of the subject EOR project. I further attest that the above 
information is true and correct and that I have provided a signed copy of this completed certificate to each person who supplied qualified carbon 
oxide to my company for use at the subject EOR project during this year.

Signature and date signed

Printed or typed name and title of person signing this report

Title

Company's name and EIN

                                                                                                                                                 Model Certificate EOR-Owner

28                                                                                                                   Instructions for Form 8933 (Rev. 12-2023)

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                                                                   Model Certificate UTZ

                                                            Utilization Certification                                                                             2023
Name(s) shown on return:                                                                                                     Identifying number:
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   In Table 1 below, list information about each owner or lessee of the carbon oxide utilization facility during the calendar year. If there’re more than 
    four owners or lessees, prepare a separate table with all the owner or lessee information and attach it to this model certificate. 
    Note. If one or more of the owners is a partnership or S corporation, provide information for the pass-through entity, not partners or shareholders.
    Table 1 — Information About the Owner(s) or Lessee(s) of the Qualified Carbon Utilization Facility
         Owner/Lessee                                Name                          Address                     EIN             Operating interest (%)
    1
    2
    3
    4
    Total
2   Name of the utilization facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
3   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                                                         Describe in more detail how the qualified carbon oxide is utilized
    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.
                                                                                                                                                                  Yes No
5.1 Do you attest that a commercial market exists for your particular product, process, or service?                . . . . . . . . . . . . . . . . . . . . . . .
5.2 Have you attached a statement substantiating that a commercial market exists? Don’t complete this model certificate unless you 
    answered “Yes” to the questions on lines 5.1 and 5.2. See instructions           . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

                                                                                                                                                         Model Certificate UTZ

Instructions for Form 8933 (Rev. 12-2023)                                                                                                                             29

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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           .
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   nonqualified COx                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              of COx                                                                                                                                                               and (J))
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             Check if supplier supplied any                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              (L) Metric tons                                     delivered to                          utilization                            facility (add                         columns (H) 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           .
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  (K) Metric 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             EPA e-GGRT                                            ID number(s)*                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        tons of COx 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           .
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    suppliers 

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    number                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     of COx 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 IRS-issued                                 registration                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 delivered to 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Total nonqualified COx from all                                                                       (J) Metric tons                                                                                                 utilization facility

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              of COx 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 Location of                                                                        (county, state)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       (I) Metric tons                                                           utilized (add                          columns (C),                          (E), and (G))
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            capture facility 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     suppliers 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   facility                               .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Total qualified COx from all                                                                                                                                                                                                              (D), and (F)) 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             Name of capture                                                                              .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               (H) Metric tons of                  COx delivered to                      utilization facility                   (add columns (B), 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
             (continued)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   tons of                                                                      COx 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               (G) Metric                                                                qualified                                                                    utilized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            EIN                                                           .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     supplier 3
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               tons of                                                                   COx 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Name of qualified COx                                              (F) Metric                                          qualified                                                                                                                        facility
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                delivered to                          utilization 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   tons of                                                                      COx 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               (E) Metric                                                                qualified                                                                    utilized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     supplier 2
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    COx                                                                                        facility
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Name                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          tons of                             qualified                                                                                                          utilization 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Name of qualified COx                                              (D) Metric                                                                                                                       delivered to 

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              tons of                                                                      COx 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          (C) Metric                                                                qualified                                                                    utilized

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                supplier 1
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          tons of                                                                   COx                                                                                        facility
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Name of qualified COx                                              (B) Metric                                          qualified                                                                                                          utilization 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           delivered to 
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       1 2 3  4
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             facility                                          Total
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Qualified COx supplier                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             lessee of                                 utilization 
                                                                                                                                                                                                                                                                                                In Table 2, provide information about all suppliers of qualified carbon oxide (COx) during the calendar year. “Qualified” COx means COx from a supplier who attests that the COx was captured at                                                                                                                                                                                                one of its 45Q facilities. “Supplier” means the person who captured the qualified COx, which may differ from the company that sold the COx or physically delivered the COx to the owner of the                                                                                                                                                                                                  utilization facility. If there’re more than three suppliers of qualified COx to the utilization facility, prepare a separate table with all information and attach it to this model certificate. Table 2 — Information About Suppliers of Qualified Carbon Oxide                                                                                                           List all suppliers of nonqualified carbon oxide                                                                                                                                                                                               Complete Table 3 below using information that conforms to the Life Cycle Assessment (LCA) that was approved by the Department of Energy and the IRS. If there’re more than four owners of the                                                                                                                                                           utilization facility or three suppliers of qualified carbon oxide, prepare a separate table with all information and attach it to this model certificate.                                                                                                                                                Check here to attest that all figures in Table 3 conform to the LCA that was subject to a technical review by the DOE, and approved by the IRS Attach a copy of the LCA approval letter from the IRS. Don’t file this model certificate if you haven’t received the approval letter. Table 3 — Information About Utilization                                                                                                       (A) Owner or 
                                                                                                                                                                                                                                                                                                6                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          7                                                                                                                                                                                                                                             8                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                9
            Part I. Information About the Carbon Utilization Facility and Utilization of Carbon Oxide                                                                                              Section 2—Information about the qualified carbon oxide supplied to the utilization facility:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          10                                                                                                                                                                                                                                                                                                                                                                                                                                                         * If available.

30                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             Instructions for Form 8933 (Rev. 12-2023)

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The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

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                                                                                                                                                                                                            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?                                                                          Title of the LCA submitted to the Department of Energy (DOE) Date (MM/DD/YYYY) the LCA was submitted to the DOE Project or LCA number assigned by the DOE Date (MM/DD/YYYY) approval letter for the utilization facility was received from the IRS Attach a copy of the approval letter from the IRS.                                            State if you’re applying the TD or the NPRM
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                                                                                                    Part I. Information About the Qualified Carbon Utilization Facility and Utilization of Carbon Oxide     11                                                                                                                                                         Part II. Information About the Life Cycle Assessment (LCA) and This Claim

Instructions for Form 8933 (Rev. 12-2023)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        31

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The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

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                                                                                                                                                                                                          Name Address  EIN                                                                                                                                                                               Supplier's name  Supplier's EIN Name and location of carbon oxide capture facility (if supplier supplied any qualified carbon oxide) Type of industrial facility at which the supplier captured its qualified carbon oxide                                                                                                                                                                   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                                                                                                                                                                                         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? Provide the date (MM/DD/YYYY) of the contract referenced in the line above or the date of the most recent contract amendment                                                                                                                                           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 in Table 3)                                                                                                                                              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 in Table 3)                                                                                                                                              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 in Table 3)                                                                                                                                                                      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 a copy of Model Certificate ELECT signed by both you and the supplier for this year
                                                                                                                                                                                                          1    2        3                                                                                                                                                                                 4                5              6                                                                                                    7                                                                                                                                                                                                                                                       8                                                                                                                                                                                                                                                                                                                                                                                                                                 9
                                    Part III. 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:                   Section 2—Information about all suppliers of qualified carbon oxide to you. Complete multiple model certificates if you had more than one supplier of qualified carbon oxide:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          10                                                                                                                                                                                                                                                                     11                                                                                                                                                                                                                                                                                                                                         12                                                                                                                                                                                                                                                                                                                                                            13                                                                                                                                                                                                                                                                                                                                                                               14

32                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Instructions for Form 8933 (Rev. 12-2023)

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      Page 5

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Model Certificate UTZ

                          (continued)

                         Utilization Certification

                                                                                                                                                                                                                       Under penalties of perjury, I attest that I am an officer of the company that’s the owner of the subject utilization project. I further attest that the above information is true and correct and that I have provided a signed copy of this completed certificate to each person who supplied qualified carbon oxide to my company for use at the subject utilization facility during this year. Signature and date signed Printed or typed name of person signing this report Title                       Company's name and EIN

Instructions for Form 8933 (Rev. 12-2023)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     33

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                                                                   Model Certificate ELECT

                                                                 Election Certification                                                                           2023
Name(s) shown on return:                                                                                                               Identifying number:
Part I. Information About Electing Taxpayer and Credit Claimant
Section 1—Electing taxpayer's information from Model Certificate CF:
1   Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
2   Address    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
3   TIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
4   Location of capture facility   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
5   Placed-in-service date of carbon capture equipment. See Rev. Rul. 2021-13, 2021-30 I.R.B. 152                            . . .    
6   Type of industrial facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
7a  IRS-issued registration number for each facility where carbon oxide was captured                     . . . . . . . . . . . . .    
7b  EPA e-GGRT ID number(s)* of each facility where carbon oxide was captured . . . . . . . . . . . . . . . .                         
Section 2—Information about the credit claimant. Complete a separate Model Certificate ELECT for each credit claimant (see 
instructions): 
8   Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
9   Address    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
10  TIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
11  Do you attest that the credit claimant isn’t a subcontractor? If you can’t answer “Yes,” you can’t elect to allow the credit claimant to                      Yes No
    claim any of your credit   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12  Check which statement applies:
    a     Credit claimant disposed of qualified carbon oxide in secure geological storage and didn’t use it as a tertiary injectant in a qualified 
          enhanced oil or natural gas recovery project, nor utilized it in a way described in section 45Q(f)(5).
    b     Credit claimant disposed of qualified carbon oxide in secure geological storage and used it as a tertiary injectant in a qualified 
          enhanced oil or natural gas recovery project.
    c     Credit claimant utilized qualified carbon oxide in a way described in section 45Q(f)(5).
13  Location of disposal site if box 12a or 12b was checked . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               
14a IRS-issued registration number for each disposal site if box 12a or 12b was checked                      . . . . . . . . . . .    
14b EPA e-GGRT ID number(s)* of each disposal site if box 12a or 12b was checked . . . . . . . . . . . . . .                          
15  Check which statement applies:
    a     Qualified carbon oxide captured using carbon capture equipment originally placed in service at a facility on or after February 9, 2018, 
          and before 2023, disposed of in secure geological storage, and not used as a tertiary injectant in a qualified enhanced oil or natural 
          gas recovery project, nor utilized in a way described in section 45Q(f)(5).
    b     Qualified carbon oxide captured using carbon capture equipment originally placed in service at a facility on or after February 9, 2018, 
          and before 2023, disposed of in secure geological storage, and used as a tertiary injectant in a qualified enhanced oil or natural gas 
          recovery project.
    c     Qualified carbon oxide captured using carbon capture equipment originally placed in service at a facility on or after February 9, 2018, 
          and before 2023, and utilized as described in section 45Q(f)(5).
    d     Qualified carbon oxide captured using carbon capture equipment originally placed in service at a facility after 2022, during the 12-year 
          period beginning on the date the equipment was originally placed in service, disposed of in secure geological storage, and not used as 
          a tertiary injectant in a qualified enhanced oil or natural gas recovery project, nor utilized as described in section 45Q(f)(5).
    e     Qualified carbon oxide captured using carbon capture equipment originally placed in service at a facility after 2022, during the 12-year 
          period beginning on the date the equipment was originally placed in service, disposed of in secure geological storage, and used as a 
          tertiary injectant in a qualified enhanced oil or natural gas recovery project.
    f     Qualified carbon oxide captured using carbon capture equipment originally placed in service at a facility after 2022, during the 12-year 
          period beginning on the date the equipment was originally placed in service, and utilized as described in section 45Q(f)(5).
16        If box 15a, 15b, or 15c was checked, check here if you elect to claim the credit rates for equipment placed in service prior to the 
          enactment of the Bipartisan Budget Act of 2018.

                                                                                                                                                         Model Certificate ELECT

34                                                                                                                     Instructions for Form 8933 (Rev. 12-2023)

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                                                                                                                                     Page 2
                                                                Election Certification (continued)
Section 2—Information about the credit claimant. Complete a separate Model Certificate ELECT for each credit claimant (see 
instructions): (continued)
17 Check the correct credit rate that applies to 2023 based on the boxes checked for lines 12, 15, and 16.
   a            $26.94 ($20 plus inflation for old equipment)
   b            $13.47 ($10 plus inflation for old equipment)
   c            $26.94 ($134.70**) for new equipment and qualified carbon oxide disposed of in secure storage and not used in EOR
   d            $13.47 ($67.35**) for new equipment and qualified carbon oxide disposed of in secure storage and used in EOR or utilized in a manner 
                described in section 45Q(f)(5)
   e            $40.89 for new equipment and qualified carbon oxide disposed of in secure storage and not used in EOR
   f            $27.61 for new equipment and qualified carbon oxide disposed of in secure storage and used in EOR or utilized in a manner described 
                in section 45Q(f)(5)
   g            $17 ($85**) for equipment placed in service after 2022 and qualified carbon oxide disposed of in secure storage and not used in EOR 
   h            $12 ($60**) for equipment placed in service after 2022 and qualified carbon oxide disposed of in secure storage and used in EOR or 
                utilized in a manner described in section 45Q(f)(5) 
   i.           $36 ($180**) for DAC equipment placed in service after 2022 and qualified carbon oxide disposed of in secure storage and not used in 
                EOR 
   j            $26 ($130**) for DAC equipment placed in service after 2022 and qualified carbon oxide disposed of in secure storage and used in 
                EOR or utilized in a manner described in section 45Q(f)(5) 
* If available. 
** If prevailing wage and apprenticeship requirement are met.
Part II. Election Information
1  If box 12a was checked, metric tons of qualified carbon oxide captured by the Electing Taxpayer and 
   disposed of in secure geological storage by the Credit Claimant and not used as a tertiary injectant in a 
   qualified enhanced oil or natural gas recovery project, nor utilized it in a way described in section 45Q(f)
   (5) (metric tons should agree with the amount on Model Certificate DISP-Owner, line 12) . . . . . . . . .                         
2  If box 12b was checked, metric tons of qualified carbon oxide captured by the Electing Taxpayer and 
   disposed of in secure geological storage by the Credit Claimant and used as a tertiary injectant in a 
   qualified enhanced oil or natural gas recovery project (metric tons should agree with the amount on 
   Model Certificate EOR-Owner, line 12)          . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
3  If box 12c was checked, metric tons of the Electing Taxpayer's qualified carbon oxide, expressed as 
   carbon dioxide equivalent, utilized in the Credit Claimant's facility and determined by an LCA (metric tons 
   should agree with the amount in Model Certificate UTZ, Part III, line 12) . . . . . . . . . . . . . . . . . . . .                 
4  Metric tons of qualified carbon oxide listed on line 1, 2, or 3, allowed by electing taxpayer to be claimed 
   by the credit claimant. Based upon the box checked in Part I, line 15, electing taxpayer adds this amount 
   to Model Certificate CF, Part III, column (a) of lines 1e, 2e, 3e, 4e, 5e, 6e, 7e, 8e, 9e, 10e, 11e, 12e, 13e, 
   14e, or 15e  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
5  2023 credit rate from line 17 of Part I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       
6  Multiply line 4 by line 5. Carbon oxide sequestration credit allowed by electing taxpayer to be claimed by 
   the credit claimant. Credit claimant adds this amount to its Form 8933, line 19 . . . . . . . . . . . . . . . .                   
7  Subtract line 4 from amount listed on lines 1, 2, or 3. Metric tons of qualified carbon oxide not allowed by 
   electing taxpayer to be claimed by the credit claimant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              
8  Multiply line 7 by line 5. Carbon oxide sequestration credit retained by the electing taxpayer . . . . . . .                      

                                                                                                                                     Model Certificate ELECT
                                                                                                                                     Page 3

Instructions for Form 8933 (Rev. 12-2023)                                                                                                          35

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                                                   Election Certification (continued)

Under penalties of perjury, I attest that I am an officer of the company that’s the owner of carbon capture equipment described in Part I, lines 1 
through 7. I further attest that the above information is true and correct.

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN

Under penalties of perjury, I attest that I am an officer of the company that’s the owner of the carbon oxide disposal, use, or utilization site described 
in Part I, lines 8 through 12. I further attest that the above information is true and correct.

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN

                                                                                               Model Certificate ELECT

36                                                                                             Instructions for Form 8933 (Rev. 12-2023)

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                                                           Model Certificate RECAPTURE

                                                           Recapture Certification                                                                          2023
Name(s) shown on return:                                                                                                                 Identifying number:
Part I. Information About the Geologic Disposal Site 
Section 1—Information about the owner(s) of the geologic disposal site:
1     Table 1 — Information About the Owner(s) of the Geologic Disposal Site
                                 2023                                    2022                                      2021                                 2020
                Name, EIN,               Operating         Name, EIN,          Operating             Name, EIN,          Operating         Name, EIN,       Operating 
                and address            interest (%)        and address         interest (%)        and address           interest (%)      and address  interest (%)
      Owner A
      Owner B
      Owner C
      Owner D
      All other 
      owners. 
      Attach a 
      complete 
      table on 
      a 
      separate 
      sheet.
Section 2—Information about the geologic disposal site or EOR project for 2023:
2     Indicate if the project is a geologic disposal site (without EOR) or an EOR project                . . . . . . . . . . . . . .    
3     Name and location (county and state) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          
4     List the name and EIN of the person who, for purposes of Regulations section 1.45Q-2(h), is the operator 
      of the project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
5     List any other companies that are identified as the operator of the project for any other purpose(s) and the 
      nature of the purpose(s)   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
6a    IRS-issued registration number(s) for geologic disposal site . . . . . . . . . . . . . . . . . . . . . . . . . . . .              
6b    EPA e-GGRT ID number(s)* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          
7     When did injection of captured carbon oxide begin (MM/YYYY)?                 . . . . . . . . . . . . . . . . . . . . . . . . .    
8     If the EOR project was previously certified under section 43, state the name of the certified project and the 
      date (MM/DD/YYYY) of the petroleum engineer's certification . . . . . . . . . . . . . . . . . . . . . . . . . . .                 
9     If the EOR project wasn’t previously certified under section 43, attach a copy of a valid petroleum engineer's certification to this Model 
      Certificate RECAPTURE.
                                                                                                                                                        Yes No
10    Is this EOR project an enhanced natural gas recovery project?              . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11–15 Reserved for future use.
16    If the amount of sequestered carbon oxide has been determined pursuant to 40 CFR Part 98 subpart RR, attach a copy of the approved 
      MRV plan or provide the URL of it on the EPA's website.
17    If the amount of sequestered carbon oxide has been determined pursuant to ISO 27916, attach a copy of the ISO 27916 documentation for 
      the calendar year. Also attach a copy of the certification by a qualified independent engineer or geologist.
* If available.
                                                                                                                                             Model Certificate RECAPTURE

Instructions for Form 8933 (Rev. 12-2023)                                                                                                                             37

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                                                                                                                                                                     Page 2
Part II. Determination of Recaptured Qualified Carbon Oxide
1  List the total metric tons of qualified carbon oxide securely stored in the geologic disposal site or EOR project during 
   2023. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
2  Metric tons of qualified carbon oxide that, during 2023, the owner, operator, or regulatory agency determined has leaked 
   from the containment area of the reservoir during 2023 or previous calendar years if not previously accounted for                         . . . . . .     
3  Metric tons of qualified carbon oxide that, during 2023, the owner, operator, or regulatory agency determined has leaked 
   from the containment area of the reservoir during 2023 or previous calendar years if not previously accounted for, and will 
   eventually migrate to the atmosphere        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     
4  If line 3 is less than line 2, attach a statement explaining how you determined that the qualified carbon oxide won’t eventually 
   migrate to the atmosphere.
5  Subtract line 1 from line 3. If greater than zero, a recapture event has occurred. This is the qualified carbon oxide subject to 
   recapture. See Regulations section 1.45Q-5(d). Complete the remainder of Part II. Don’t complete this model certificate if a 
   recapture event didn’t occur    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     
6  Attach a statement describing the cause of the leakage of qualified carbon oxide.
7  Which regulatory agencies were made aware of the leakage of qualified carbon oxide? . . . . . . . . . . . . . . . . . . . . . .                           
8  Attach a copy of Model Certificate DISP-Operator or Model Certificate EOR-Operator for this disposal site for each of the previous THREE 
   calendar years.
9  Complete Table 2 below. 
10 In column (C), list the amount of total carbon oxide stored in each of the THREE calendar years prior to the current calendar year. This would be 
   from Model Certificate EOR-Operator, Table 3, column (M), row (5), for each year.
11 In columns (E), (F), (G), (H), and (I), allocate the amount in column (D) to each owner of the geologic disposal site or EOR project for each year. 
   Check the box if the carbon oxide was qualified. Use two columns for any owner that stored both qualified and nonqualified carbon oxide. If 
   more columns are needed, attach a separate table that shows the allocation for all owners. You should allocate the amount of stored carbon 
   oxide on a pro rata basis, using figures from Model Certificate EOR-Operator, Table 3, of each year, unless there is a sound engineering basis to 
   do otherwise.
12 Check here if the allocation of the amounts in column (D) were done in a manner other than pro rata and attach an explanatory 
   statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
   Table 2 — Information About Stored Carbon Oxide Subject to Recapture
                           (C)                                                         Allocation of stored carbon oxide subject to recapture
                         Metric                                            (E)             (F)           (G)           (H)             (I)           (J)          (K)
                         tons of                           Owner 
                         stored                            name                                                                                Reserved           Total. Add 
                         carbon                            and EIN                                                                               for future      columns (E) 
                         oxide                                                                                                                     use            through (I)
                                         (D) Stored 
       (A)                 from 
               (B)                     carbon oxide  Check if 
   Year                Table 3 of                        carbon 
               Year                      subject to 
   prior                   the                           oxide 
                                         recapture*
                       applicable                        was 
                        Operator                         qualified                                                                        
                       Certificate                       carbon 
                          for the                        oxide
                       indicated 
                           year
   (1) 1st   2022
   (2) 2nd   2021
   (3) 3rd   2020
   (4) Total. Add 
   rows (1) 
   through (3).
   (5) Subtract Part II, line 5, 
   from column (D), row (4). 
   Metric tons of carbon 
   oxide not subject to 
   recapture due to 
   look-back being limited 
   to THREE calendar 
   years.
13 Provide a copy of Parts I and II to each owner of the disposal site or EOR project during the current and THREE previous calendar years.

                                                                                                                                                 Model Certificate RECAPTURE

38                                                                                                                     Instructions for Form 8933 (Rev. 12-2023)

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                                                                                                                                            Page 3
                                                                 Recapture Certification (continued)

Under penalties of perjury, I attest that I am an officer of the company that’s the operator of the subject geologic disposal site or the subject EOR 
project or have been designated by the operating interest owners to prepare and submit this certificate to the IRS on their behalf. I further attest that 
the above qualified carbon oxide sequestration credit recapture information is true and correct.

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN

Part III. Determination of Recaptured Qualified Carbon Oxide for Supplier
Part III will be prepared by each owner of the disposal site or EOR project during the current and THREE previous calendar years. Part III will be 
used to determine the amount of qualified carbon oxide sequestration credit that needs to be recaptured. A separate Part III should be completed for 
each supplier of qualified carbon oxide during the current and THREE previous calendar years and a copy should be given to each supplier.

Information about you, the owner of the EOR project:
1    Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
2    Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
3    EIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  

Information about suppliers who supplied carbon oxide during any of the THREE previous calendar years. COMPLETE A PART III FOR 
EACH SUPPLIER: 
4    Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
5    EIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
6    Name and location of carbon oxide capture facility (if supplier supplied any qualified carbon oxide) . . . . . .                       
7    Type of industrial facility at which the supplier captured its qualified carbon oxide . . . . . . . . . . . . . . . . .                
8    Complete Table 5 using information from Table 3 of Model Certificate EOR for the previous THREE calendar years. Complete a separate Table 
     5 for each supplier of qualified carbon oxide during the previous THREE calendar years. If one supplier supplied qualified carbon oxide from 
     multiple facilities, complete a Table 5 for each facility.

                                                                                                                                            Model Certificate RECAPTURE

Instructions for Form 8933 (Rev. 12-2023)                                                                                                             39

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                                                                                                                                                        Page 4
                                                                  Recapture Certification (continued)
     Table 5 — Information About Carbon Oxide Sequestration Credit Subject to Recapture by Supplier
                                                            Supplier Name:
                                                                                                                          (H) Amount 
                                                                                                                            of carbon 
                                                                                                                                        (I) Metric tons (J) Amount of 
                                                                                                                              oxide 
                                                                                                                                        of carbon oxide carbon oxide 
                                                                                                                        sequestration
                                                                                                                                        for which the   sequestration 
                                                                                                  (G) Metric tons of         credit for 
                          (C) Total                                                                                                     supplier didn’t  credit for which 
                                                              (E) Your                              carbon oxide for      which the 
                            metric                                                                                                      elect to allow  the supplier 
                                            (D) Total         amount of         (F) Rate of             which the           supplier 
                          tons of                                                                                                       you to claim    didn’t elect to 
         (A)                            metric tons of        qualified       carbon oxide          supplier elected      elected to 
                  (B)       stored                                                                                                      the carbon      allow you to 
         Year                           stored carbon           carbon        sequestration         to allow you to       allow you to 
                Year      carbon                                                                                                        oxide           claim the 
         prior                          oxide subject           oxide         credit for the      claim the carbon          claim the 
                            oxide                                                                                                       sequestration   carbon oxide 
                                          to recapture        subject to        year ($/MT)               oxide         carbon oxide 
                            from                                                                                                        credit (MT).    sequestration 
                                                              recapture                             sequestration       sequestration
                          Table 2                                                                                                       Subtract        credit ($). 
                                                                                                      credit (MT)          credit ($). 
                                                                                                                                        column (G)      Multiply 
                                                                                                                            Multiply 
                                                                                                                                        from column     column (I) by 
                                                                                                                          column (G) 
                                                                                                                                        (E).            column (F).
                                                                                                                          by column 
                                                                                                                                (F).
     (1) 1st    2022
     (2) 2nd    2021
     (3) 3rd    2020
     (4) Total metric tons. Add rows (1) through (3)        . . . . . . . . . . . . . . . .
     (5) Amount of carbon oxide sequestration credit you must recapture this year for carbon oxide 
         supplied by this supplier. Add rows (1) through (3). Add to your Form 8933, Part III, 
         line 22. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
     (6) Total metric tons. Add rows (1) through (3)        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
     (7) Amount of carbon oxide sequestration credit the supplier of carbon oxide must recapture this year. Add rows (1) through 
         (3). The supplier must add this amount to its Form 8933, Part III, line 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under penalties of perjury, I attest that I am an officer of the company that’s the owner of the subject geologic disposal site or the subject EOR 
project. I further attest that the above information is true and correct and that I have provided a signed copy of this completed recapture certificate to 
each person.

Signature and date signed

Printed or typed name of person signing this report

Title

Company's name and EIN

                                                                                                                                        Model Certificate RECAPTURE

40                                                                                                                    Instructions for Form 8933 (Rev. 12-2023)

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Paperwork Reduction Act Notice.                We ask for the information on this form to carry out the Internal Revenue laws of the 
United States. You are required to give us the information. We need it to ensure that you are complying with these laws 
and to allow us to figure and collect the right amount of tax.
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act 
unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be 
retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax 
returns and return information are confidential, as required by section 6103.
The time needed to complete and file this form will vary depending on individual circumstances. The estimated burden 
for individual and business taxpayers filing this form is approved under OMB control number 1545-0074 and 1545-0123 
and is included in the estimates shown in the instructions for their individual and business income tax return. The 
estimated burden for all other taxpayers who file this form is shown below.

Recordkeeping. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 hr., 43 min.
Learning about the law or the form. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          2 hr., 9 min.
Preparing and sending the form to the IRS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               3 hr., 39 min.

If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, 
we would be happy to hear from you. See the instructions for the tax return with which this form is filed.

Instructions for Form 8933 (Rev. 12-2023)                                                                                                                    41

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