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AH XSL/XML Fileid: … ns/i8933/202212/a/xml/cycle06/source (Init. & Date) _______

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Department of the Treasury
Internal Revenue Service
Instructions for Form 8933

(Rev. December 2022)
Carbon Oxide Sequestration Credit

Section references are to the Internal Revenue Code Credit rates and applicable dollar amounts. The
unless otherwise noted. credit rates for lines 1b, 2b, and 3b are adjusted for
inflation and increased, per Notice 2022-38. The
Future Developments applicable dollar amounts for lines 4b, 5b, and 6b are
For the latest information about developments related to established by linear interpolation between statutory dollar
Form 8933 and its instructions, such as legislation amounts and increased, per Notice 2018-93. See 2022
enacted after they were published, go to IRS.gov/ credit rates and applicable dollar amounts.
Form8933.
Continuous-use form. Form 8933 will no longer be
What’s New updated annually. Instead, it will only be updated when
necessary.
Section 45Q was impacted by the Inflation
Reduction Act of 2022 (the Act) and further Section 45Q(f)(3)(B) election. Line 13 and its
CAUTION! guidance is pending for some of the changes instructions are expanded to include the individual listing
listed below. For upcoming section 45Q regulations and of the three largest elections (in dollars) given to you by
IRS notices, go to IRS.gov or IRS.gov/Form8933. another person(s). See Line 13. Section 45Q(f)(3)(B)
Election, later.
A summary of major changes to section 45Q is as
follows, the Act: Reminders
• Extended the deadline to begin construction of qualified Proposed and final regulations, model certificates,
facility from 2026 to 2033. and expanded Form 8933. Per the January 2021
• Changed the base rate for section 45Q(b)(1)(A)(i)(I) Treasury Decision 9944 (TD) (final regulations for section
and (ll) rates to $17 and $12 ($85 and $60 if section 45Q) and the June 2020 Notice of Proposed Rulemaking
45Q(h)(2) requirements are met), respectively, for tax (NPRM) (REG-112339-19) that preceded it, section 45Q
years beginning after 2022. projects may involve multiple legal contracts with multiple
• Changed the base rate for section 45Q(b)(1)(B)(i) and parties for the capture, utilization, or disposal of carbon
(ii) rates to $36 and $26 ($180 and $130 if section 45Q(h) oxides and, generally to claim the credit, the existence of
(2) requirements are met), respectively, for direct air each contract and the parties involved must be reported
capture facilities, for tax years beginning after 2022. on Form 8933 annually, including these attached
• Reduced annual thresholds of captured carbon oxide documents: copies of signed executed contracts,
for qualified electric generating facility, a qualified direct completed Forms 8933, and attached signed statements,
air capture facility, and any other facility. See Qualified all of which must be exchanged between the contracting
facility. parties for certain elections and contracts. For this
• Changed credit reduction percentage to 15%. See reporting, filers should use signed attachments
Coordination With Section 142 Bond Financing. substantially similar to the model certificates shown at the
• Added definitions for new terms, including Applicable end of these instructions. In these exchanges of Forms
electric generating unit Baseline carbon oxide production, , 8933, signed contracts, or signed attachments
and Capacity factor. substantially similar to the signed model certificates, the
• Allows the section 45Q(f)(9) election for carbon oxide Forms 8933 won't be signed.
captured and disposed of after 2021 for a qualified facility
located in a federally declared disaster area. See Section Note. For tax years beginning on or after January 13,
45Q(f)(9) Election. 2021, you must follow the provisions of the TD. For all
• Made prevailing wage and apprenticeship other 2021 tax years you may elect to apply either the
requirements. See Notice 2022-61, 2022-52 I.R.B. 561, provisions of the NPRM or of the TD, but you must apply
available at IRS.gov/irb/2022-52_IRB#NOT-2022-61, them in their entirety and in a consistent manner.
Prevailing Wage Requirements, and Apprenticeship Credit reduced for certain tax-exempt bonds. A
Requirements to determine your qualification for the qualified section 45Q facility can be financed with exempt
increased credit or deduction amounts by meeting the facility bonds issued after December 31, 2021. The
prevailing wage and apprenticeship requirements. section 45Q credit is reduced for qualified section 45Q
• Made payment options for the credits, for which facilities financed with exempt facility bonds. See
regulations and guidance are pending. See Elective Coordination With Section 142 Bond Financing, later.
Payment of Applicable Credits and Transfer of Carbon
Oxide Sequestration Credits.

Jan 5, 2023 Cat. No. 74390F

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                                                                  the equipment was originally placed in service, (2) 
General Instructions                                              disposed of by you in secure geological storage, and (3) 
                                                                  neither used as a tertiary injectant in a qualified EOR or 
Purpose of Form                                                   natural gas recovery project nor utilized in a manner 
Use Form 8933 to claim the section 45Q carbon oxide               described in section 45Q(f)(5).
sequestration credit. See Definitions, later.                           Section 45Q(a)(4) allows a credit of the applicable 
For purposes of this form, a partner in a partnership             dollar amount (as determined under section 45Q(b)(1)) 
that has made a valid section 761(a) election will be             per metric ton of qualified carbon oxide (1) captured by 
considered the taxpayer. Partnerships with valid section          you using carbon capture equipment that’s originally 
761(a) elections aren’t required to complete or file this         placed in service at a qualified facility on or after February 
form. Instead, the partner is required to complete and file       9, 2018, during the 12-year period beginning on the date 
this form in a manner commensurate with its undivided             the equipment was originally placed in service; and (2) 
ownership interest in the qualified facility. Also, see Rev.      either (a) used by you as a tertiary injectant in a qualified 
Proc. 2020-12, 2020-11, I.R.B. 511, for allocation safe           EOR or natural gas recovery project and disposed of by 
harbor. However, if you elect to use the TD, the section          you in secure geological storage, or (b) utilized in a 
761(a) election applies only in the case of qualified carbon      manner described in section 45Q(f)(5).
oxide captured using carbon capture equipment that's                    For purposes of determining the credit, you may elect 
originally placed in service at a qualified facility before       under section 45Q(b)(3) to have the dollar amounts 
February 9, 2018. For qualified carbon oxide captured             applicable under section 45Q(a)(1) or (2) apply in lieu of 
using carbon capture equipment that's originally placed in        the dollar amounts applicable under section 45Q(a)(3) or 
service at a qualified facility on or after February 9, 2018,     (4) for each metric ton of qualified carbon oxide that’s 
for each single process train of carbon capture equipment         captured by you using carbon capture equipment that’s 
(as described in Regulations section 1.45Q-2(c)(3)), only         originally placed in service at a qualified facility on or after 
one taxpayer will be considered the person to whom the            February 9, 2018.
credit is attributable and only that person may claim the 
carbon oxide sequestration credit. See Regulations                      For the purpose of calculating the credit, a metric ton of 
section 1.45Q-1(h)(1).                                            carbon oxide includes only the contained weight of the 
                                                                  carbon oxide. The weight of any other substances, such 
Taxpayers other than partnerships or S corporations               as water or impurities, isn’t included in the calculation.
whose only source of this credit is from those 
                                                                  2022 credit rates and applicable dollar amounts.          The 
pass-through entities (other than a partnership with a valid 
                                                                  credit rates for lines 1b, 2b, and 3b are increased by the 
761(a) election) aren’t required to complete or file this 
                                                                  adjustment for inflation. The rates are as follows.
form. Instead, report this credit directly on line 1x in Part III 
of Form 3800, General Business Credit.                                • Line 1b: $25.07 per metric ton.
                                                                      • Line 2b: $12.53 per metric ton.
How To Figure the Credit                                              • Line 3b: $12.53 per metric ton.
Subject to the section 45Q(f)(3)(B) election (discussed                 See Notice 2022-38, 2022-39 I.R.B. 239, available at 
later), section 45Q(a)(1) allows a credit of $20 per metric       IRS.gov/irb/2022-39_IRB#NOT-2022-38.
ton of qualified carbon oxide captured by you using                     For any tax year beginning in a calendar year after 
carbon capture equipment that’s (1) originally placed in          2016 and before 2027, the section 45Q(b)(1)(A) 
service at a qualified facility before February 9, 2018, (2)      applicable dollar amounts for lines 4b, 5b, and 6b are 
disposed of by you in secure geological storage, and (3)          established by linear interpolation between $22.66 and 
not used by you as a tertiary injectant in a qualified            $50, and $12.83 and $35, respectively. The applicable 
enhanced oil recovery (EOR) or natural gas recovery               dollar amounts are as follows.
project or utilized by you in a manner described in section           • Line 4b: $37.85 per metric ton.
45Q(f)(5).                                                            • Line 5b: $25.15 per metric ton.
Section 45Q(a)(2) allows a credit of $10 per metric ton               • Line 6b: $25.15 per metric ton.
of qualified carbon oxide (1) captured by you using carbon              See Notice 2018-93, 2018-51 I.R.B. 1041, available at 
capture equipment that’s originally placed in service at a        IRS.gov/irb/2018-51_IRB#NOT-2018-93.
qualified facility before February 9, 2018; and (2) either (a)          After 2022, the applicable dollar amounts are as 
used by you as a tertiary injectant in a qualified EOR or         follows.
natural gas recovery project and disposed of by you in                • Line 4b: $17 per metric ton ($85 per metric ton if section 
secure geological storage, or (b) utilized by you in a            45Q(h)(2) requirements are met).
manner described in section 45Q(f)(5).                                • Line 5b: $12 per metric ton ($60 per metric ton if section 
Section 45Q(a)(3) allows a credit of the applicable               45Q(h)(2) requirements are met).
dollar amount (as determined under section 45Q(b)(1))                 • Line 6b: $12 per metric ton ($60 per metric ton if section 
per metric ton of qualified carbon oxide (1) captured by          45Q(h)(2) requirements are met).
you using carbon capture equipment that’s originally                    For direct air capture facilities placed in service after 
placed in service at a qualified facility on or after February    2022, the section 45Q(b)(1)(B) applicable dollar amounts 
9, 2018, during the 12-year period beginning on the date          are as follows.

                                                                  -2-            Instructions for Form 8933 (Rev. 12-2022)

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• Line 7b: $36 per metric ton ($180 per metric ton if                oxide from the atmosphere via direct air capture; or (3) 
section 45Q(h)(2) requirements are met).                             compressing or otherwise increasing the pressure of 
• Line 8b: $26 per metric ton ($130 per metric ton if                carbon oxide.
section 45Q(h)(2) requirements are met).                               All components that make up an independently 
• Line 9b: $26 per metric ton ($130 per metric ton if                functioning process train capable of capturing, 
section 45Q(h)(2) requirements are met).                             processing, and preparing carbon oxide for transport will 
Amount captured by additional carbon capture                         be treated as a single unit of carbon capture equipment 
equipment on existing qualified facility. For a                      (single process train). See Rev. Rul. 2021-13, 2021-30 
qualified facility placed in service before February 9, 2018,        I.R.B. 152, available at IRS.gov/irb/2021-30_IRB#REV-
for which additional carbon capture equipment is placed in           RUL-2021-13.
service on or after February 9, 2018, the amount of                  Applicable electric generating unit. An applicable 
qualified carbon oxide that’s captured by you is the                 electric generating unit is the principal electric generating 
following.                                                           unit for which the carbon capture equipment is originally 
• For purposes of lines 1, 2, and 3, equal to the lesser of          planned and designed.
(a) the total amount of qualified carbon oxide captured at 
such facility for the tax year, or (b) the total amount of the       Baseline carbon oxide production. A baseline carbon 
carbon dioxide capture capacity of the carbon capture                oxide production means either of the following.
equipment in service at such facility on the day before              • In the case of an applicable electric generating unit that 
February 9, 2018.                                                    was originally placed in service more than 1 year prior to 
• For purposes of lines 4, 5, and 6, an amount (not less             the date on which construction of the carbon capture 
than zero) equal to the excess of (a) the total amount of            equipment begins, the average annual carbon oxide 
qualified carbon oxide captured at such facility for the tax         production, by mass, from such unit during (i) in the case 
year, over (b) the total amount of the carbon dioxide                of an applicable electric generating unit that was originally 
capture capacity of the carbon capture equipment in                  placed in service more than 1 year prior to the date on 
service at such facility on the day before February 9,               which construction of the carbon capture equipment 
2018.                                                                begins and on or after the date that’s 3 years prior to the 
                                                                     date on which construction of such equipment begins, the 
Definitions                                                          period beginning on the date such unit was placed in 
                                                                     service and ending on the date on which construction of 
Qualified carbon oxide. This is (a) any carbon dioxide               such equipment began; and (ii) in the case of an 
captured from an industrial source by carbon capture                 applicable electric generating unit that was originally 
equipment originally placed in service before February 9,            placed in service more than 3 years prior to the date on 
2018, which would otherwise be released into the                     which construction of the carbon capture equipment 
atmosphere as industrial emission of greenhouse gas or               begins, the 3 years with the highest annual carbon oxide 
lead to such release, and is measured at the source of               production during the 12-year period preceding the date 
capture and verified at the point of disposal, injection, or         on which construction of such equipment began.
utilization; (b) any carbon dioxide or other carbon oxide              In the case of an applicable electric generating unit that 
                                                                     •
that’s captured from an industrial source by carbon                  (i) as of the date on which construction of the carbon 
capture equipment originally placed in service on or after           capture equipment begins, is not yet placed in service; or 
February 9, 2018, which would otherwise be released into             (ii) was placed in service during the 1-year period prior to 
the atmosphere as industrial emission of greenhouse gas              the date on which construction of the carbon capture 
or lead to such release, and is measured at the source of            equipment begins, the designed annual carbon oxide 
capture and verified at the point of disposal, injection, or         production, by mass, as determined based on an 
utilization; or (c) in the case of a direct air capture facility,    assumed capacity factor of 60%.
any carbon dioxide that’s captured directly from the 
                                                                       Capacity factor.   Capacity factor means the ratio 
ambient air, and is measured at the source of capture and 
                                                                     (expressed as a percentage) of the actual electric output 
verified at the point of disposal, injection, or utilization.
                                                                     from the applicable electric generating unit to the potential 
  Qualified carbon oxide includes the initial deposit of             electric output from such unit.
captured carbon oxide used as a tertiary injectant. It 
doesn’t include carbon oxide that’s recaptured, recycled,            Industrial facility. An industrial facility is a facility that 
and re-injected as part of the EOR and natural gas                   produces a carbon oxide stream from a fuel combustion 
recovery process.                                                    source or fuel cell, a manufacturing process, or a fugitive 
                                                                     carbon oxide emission source that, absent capture and 
Carbon capture equipment.  This includes all                         disposal, would otherwise be released into the 
components of property that are used to capture or                   atmosphere as industrial emission of greenhouse gas or 
process carbon oxide until the carbon oxide is transported           lead to such release. An industrial facility doesn’t include 
for disposal, injection, or utilization. Carbon capture              a facility that produces carbon dioxide from carbon 
equipment is equipment used for the purpose of (1)                   dioxide production wells at natural carbon dioxide-bearing 
separating, purifying, drying, and/or capturing carbon               formations or a naturally occurring subsurface spring. 
oxide that would otherwise be released into the                      Depending on your election to use the NPRM or the TD, 
atmosphere from an industrial facility; (2) removing carbon          see section 3.02(b) of Notice 2009-83 or Proposed 

Instructions for Form 8933 (Rev. 12-2022)                         -3-

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Regulations section 1.45Q-2(d)(1) or Regulations section        Secure geological storage. Secure geological storage 
1.45Q-2(d)(1) and (d)(2). An Industrial Source is an            includes, but isn’t limited to, storage at deep saline 
emission of carbon oxide from an industrial facility. A         formations, oil and gas reservoirs, and unminable coal 
Manufacturing Process is a process involving the                seams.
manufacture of products, other than carbon oxide, that are 
                                                                      If you’re claiming a credit for a facility placed in service 
intended to be sold at a profit, or are used for a 
                                                                before February 9, 2018, the following applies.
commercial purpose. All facts and circumstances for the 
process and products are to be taken into account.                  • Secure geological storage requires approval by the 
                                                                U.S. Environmental Protection Agency (EPA) of a 
Electricity generating facility. An electricity generating      Monitoring, Reporting, and Verification Plan (MRV Plan) 
facility is a facility described in section 45Q(d)(2)(A) or (B) submitted by the operator of the storage facility or tertiary 
and is subject to depreciation under MACRS asset class          injection project.
49.11 (Electric Utility Hydraulic Production Plant), 49.12          • The annual amount of carbon oxide claimed for the 
(Electric Utility Nuclear Production Plant), 49.13 (Electric    credit must be consistent with amounts reported to the 
Utility Steam Production Plant), or 49.15 (Electric Utility     EPA under its Greenhouse Gas Reporting Program, 
Combustion Turbine Production Plant).                           subpart RR.
Direct air capture facility. A direct air capture facility            See sections 6 through 8 of Notice 2009-83, 2009-44 
means any facility that uses carbon capture equipment to        I.R.B. 588, available at IRS.gov/irb/
capture carbon oxide directly from the ambient air. It          2009-44_IRB#NOT-2009-83 for reporting and 
doesn’t include any facility that captures carbon dioxide       recordkeeping requirements associated with the limitation 
(1) that’s deliberately released from naturally occurring       on credits available under former section 45Q(a) (as in 
subsurface springs, or (2) using natural photosynthesis.        effect before February 9, 2018) and sections 45Q(a)(1) 
                                                                and (2). Sections 1 through 5 of Notice 2009-83 were 
Qualified facility. Any industrial facility or direct air 
                                                                obsoleted by REG-112339-19, 85 F.R. 34050-34075. 
capture facility (a) the construction of which begins before 
                                                                After the end of the calendar year in which the Secretary, 
January 1, 2033, and the construction of carbon capture 
                                                                in consultation with the Administrator of the EPA, certifies 
equipment begins before that date, or the original 
                                                                that a total of 75,000,000 metric tons of qualified carbon 
planning and design for the facility includes installation of 
                                                                oxide have been taken into account under former section 
carbon capture equipment; and (b) which captures:
                                                                45Q(a) (as in effect before February 9, 2018) and sections 
1. In the case of a direct air capture facility, captures       45Q(a)(1) and (2), the remaining sections of Notice 
not less than 1,000 metric tons of qualified carbon oxide       2009-83 will be obsoleted. Also see Notice 2022-38.
during the tax year;
                                                                      If you’re claiming a credit for a facility that was placed in 
2. In the case of an electricity generating facility that (i)   service in tax years beginning on or after February 9, 
captures not less than 18,750 metric tons of qualified          2018, qualified carbon oxide is considered disposed of by 
carbon oxide during the tax year; and (ii) for any carbon       you in secure geological storage such that the qualified 
capture equipment for the applicable electric generating        carbon oxide doesn’t escape into the atmosphere if the 
unit at such facility, has a capture design capacity of not     qualified carbon oxide is:
less than 75% of the baseline carbon oxide production of            • Stored, and not used as a tertiary injectant in a qualified 
such unit; or                                                   EOR or natural gas recovery project, in compliance with 
3. In the case of any other facility, captures not less         applicable requirements under 40 CFR Part 98 subpart 
than 12,500 metric tons of qualified carbon oxide during        RR;
the tax year.                                                       • Used as a tertiary injectant in a qualified EOR or natural 
                                                                gas recovery project and stored in compliance with 
Qualified EOR or natural gas recovery project.     A            applicable requirements under 40 CFR Part 98 subpart 
qualified EOR or natural gas recovery project means any         RR, or the International Organization for Standardization 
project located in the United States involving the              (ISO) Standards endorsed by the American National 
application of one or more tertiary recovery methods            Standards Institute (ANSI) under CSA/ANSI ISO 
defined in section 193(b)(3) that can reasonably be             27916:19, Carbon dioxide capture, transportation and 
expected to result in more than an insignificant increase in    geological storage—Carbon dioxide storage using 
the amount of crude oil or natural gas that will ultimately     enhanced oil recovery (CO2-EOR); and
be recovered and for which the first injection of liquids,          • Injected into a well that complies with applicable 
gases, or other matter begins after 1990.                       Underground Injection Control regulations onshore or 
Natural gas.  Natural gas means any product (other than         offshore under submerged lands within the territorial 
crude oil) of an oil or gas well if a deduction for depletion   jurisdiction of the United States.
is allowable under section 611 for such product.                Utilization of qualified carbon oxide. Utilization of 
Tertiary injectant. An injectant (other than a                  qualified carbon oxide means (1) the fixation of such 
hydrocarbon injectant that’s recoverable) that’s used as        qualified carbon oxide through photosynthesis or 
part of a tertiary recovery method. For more details, see       chemosynthesis, such as through the growing of algae or 
section 193(b).                                                 bacteria; (2) the chemical conversion of such qualified 
                                                                carbon oxide to a material or chemical compound in which 

                                                                -4-               Instructions for Form 8933 (Rev. 12-2022)

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such qualified carbon oxide is securely stored; or (3) the        service at a qualified facility before February 9, 2018, if 
use of such qualified carbon oxide for any other purpose          you’re the person that captures and physically or 
for which a commercial market exists (with the exception          contractually ensures the disposal, injection, or utilization 
of use as a tertiary injectant in a qualified EOR or natural      of the qualified carbon oxide, the credit is attributable to 
gas recovery project), as determined by the Secretary of          you. You may claim the credit, or you may elect to allow 
the Treasury or his delegate.                                     the credit to the person that disposes of, injects, or utilizes 
                                                                  the qualified carbon oxide. If you make this election, the 
United States and U.S. possessions. This includes the 
                                                                  amount you elect to allow won’t be allowed to you. You 
seabed and subsoil of those submarine areas that are 
                                                                  can also elect to allow only part of the credit to the person 
adjacent to the territorial waters of the United States (or a 
                                                                  that disposes of, injects, or utilizes the qualified carbon 
U.S. possession) and over which the United States has 
                                                                  oxide in a tax year, and to claim the remainder yourself.
exclusive rights, in accordance with international law, for 
the exploration and exploitation of natural resources.              In the case of qualified carbon oxide captured using 
                                                                  carbon capture equipment that’s originally placed in 
Who Can Claim the Credit
                                                                  service at a qualified facility on or after February 9, 2018, if 
The credit is attributable to you in the case of qualified        you’re the person that owns the carbon capture 
carbon oxide captured using carbon capture equipment              equipment and physically or contractually ensures the 
that’s originally placed in service at a qualified facility on    capture and disposal, utilization, or use as a tertiary 
or after February 9, 2018, if you’re the person that owns         injectant of such carbon oxide, you may check the box to 
the carbon capture equipment and physically or                    elect to allow the credit to another person that disposes 
contractually ensures the disposal, utilization, or use as a      of, injects, or utilizes the qualified carbon oxide. If you 
tertiary injectant of this qualified carbon oxide.                make this election, the amount you elect to allow won’t be 
Elections                                                         allowed to you. You can also elect to allow only part of the 
                                                                  credit to the person that disposes of, injects, or utilizes the 
Section 45Q(b)(3) Election                                        qualified carbon oxide in a tax year, and to the claim the 
                                                                  remainder yourself.
You can elect to have the credit rates applicable to lines 
1b, 2b, and 3b apply instead of the applicable dollar               A new section 45Q(f)(3)(B) election must be made 
amounts applicable to lines 4b, 5b, and 6b for each metric        annually. You make a section 45Q(f)(3)(B) election by 
ton of qualified carbon oxide that’s captured by you using        filing a statement of election (see Model Certificate 
carbon capture equipment that’s originally placed in              ELECT, later, and the information below) with the Form 
service at a qualified facility on or after February 9, 2018.     8933 no later than the time prescribed by law (including 
                                                                  extensions) for filing your federal income tax return or 
Section 45Q(f)(6) Election
                                                                  Form 1065 for the year in which the credit arises. You 
For purposes of section 45Q, for any tax year in which            must make a separate election for each qualified facility.
such facility is an applicable facility (a facility placed in 
service before February 9, 2018, and for which no                          The election may not be filed with an amended 
taxpayer claimed a carbon oxide sequestration credit for                   federal income tax return, an amended Form 
any tax year ending before February 9, 2018) that                 CAUTION! 1065, or an Administrative Adjustment Request 
captures not less than 500,000 metric tons of qualified           (AAR), as applicable, after the prescribed date (including 
carbon oxide during the tax year, you can elect to have           extensions) for filing the original federal income tax return 
the facility, and any carbon capture equipment placed in          or Form 1065 for the year, with the exception of amended 
service at the facility, treated as placed in service on          federal income tax returns, amended Forms 1065, or 
February 9, 2018.                                                 AARs, as applicable, for any tax year ending after 
                                                                  February 9, 2018, and beginning on or before January 13, 
You make a section 45Q(f)(6) election by filing a                 2021. The amended federal income tax return or the 
statement of election with your income tax return for each        amended Form 1065 must be filed, in no event, later than 
tax year in which the credit arises. In addition to any           the applicable period of limitations on assessment for the 
information required on Form 8933, your statement of              tax year for which the amended federal income tax return 
election must show your name, address, taxpayer                   or Form 1065 is being filed.
identification number, location, and the identification 
number(s) assigned to the facility by the EPA's electronic        Information required to be provided by electing tax-
Greenhouse Gas Reporting Tool (e-GGRT ID number(s))               payer. 
(if available).                                                   • Election statement of the electing taxpayer on Form 
                                                                  8933 must indicate that an election is being made under 
Note. EPA e-GGRT ID number(s) are identification                  section 45Q(f)(3)(B);
number(s) assigned to the facility by the EPA's electronic        • The electing taxpayer must provide each credit 
Greenhouse Gas Reporting Tool.                                    claimant with a copy of the electing taxpayer’s Form 8933; 
                                                                  and
Section 45Q(f)(3)(B) Election                                     • The electing taxpayer must, in addition to any 
In the case of qualified carbon oxide captured using              information required on Form 8933, set forth the following 
carbon capture equipment that’s originally placed in              information.

Instructions for Form 8933 (Rev. 12-2022)                      -5-

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    1. The electing taxpayer’s name, address, taxpayer         capture equipment after such equipment is originally 
identification number, location, and e-GGRT ID number(s)       placed in service.
(if available) of each qualified facility where carbon oxide 
was captured;                                                  Application of Section 45Q for Certain 
    2. The full amount of credit attributable to the taxpayer  Carbon Capture Equipment
prior to the election;                                         In the case of any carbon capture equipment placed in 
    3. The name, address, and taxpayer identification          service before February 9, 2018, the credit will apply to 
number of each credit claimant, and the location and EPA       qualified carbon oxide captured using such equipment 
e-GGRT ID number(s) (if available) of each secure              before the end of the calendar year in which the 
geological storage facility where the qualified carbon         Secretary, in consultation with the Administrator of the 
oxide is disposed of or injected;                              EPA, certifies that, during the period beginning after 
    4. The dollar amount of credits the taxpayer is allowing   October 3, 2008, a total of 75,000,000 metric tons of 
each credit claimant to claim and the corresponding            qualified carbon oxide have been taken into account in 
metric tons of qualified carbon oxide; and                     accordance with section 45Q(a), as in effect on the day 
                                                               before February 9, 2018, and section 45Q(a)(1) and (2).
    5. The dollar amount of credits retained by the electing 
taxpayer and the corresponding metric tons of qualified            Effective August 16, 2022, in the case of any carbon 
carbon oxide.                                                  capture equipment placed in service before February 9, 
                                                               2018, the credit will apply to qualified carbon oxide 
Information required to be provided by credit claim-           captured using such equipment before the earlier of 
ant. Credit claimant must include the following                January 1, 2023, and the end of the calendar year in 
information on Form 8933 with its timely filed federal         which the Secretary, in consultation with the Administrator 
income tax return or Form 1065 (including extensions).         of the EPA, certifies that during the period beginning after 
• The name, address, and taxpayer identification number        October 3, 2008, a total of 75,000,000 metric tons of 
of the credit claimant;                                        qualified carbon oxide have been taken into account in 
• The name, address, and taxpayer identification number        accordance with section 45Q(a), as in effect on the day 
of each taxpayer making an election under section 45Q(f)       before February 9, 2018, and section 45Q(a)(1) and (2).
(3)(B) to allow the credit to the credit claimant;
• The location and EPA e-GGRT ID number(s) (if                 When Construction Begins
available) of each qualified facility where carbon oxide       Two methods can be used to establish that construction of 
was captured;                                                  a qualified facility or carbon capture equipment has 
• The location and EPA e-GGRT ID number(s) (if                 begun.
available) of each secure geological storage facility where 
the qualified carbon oxide is disposed of or injected;             1. Physical Work Test is satisfied when physical 
• The full dollar amount of credits attributable to each       work of a significant nature begins and other requirements 
electing taxpayer prior to the election and the                provided in section 5 of Notice 2020-12, 2020-11 I.R.B. 
corresponding metric tons of carbon oxide;                     495, available at IRS.gov/irb/2020-11_IRB#NOT-2020-12, 
• The dollar amount of credits that each electing taxpayer     are met.
is allowing the credit claimant to claim and the                   2. Five Percent Safe Harbor is satisfied when you 
corresponding metric tons of carbon oxide; and                 pay or incur (within the meaning of Regulations section 
• A copy of the electing taxpayer’s Form 8933.                 1.461-1(a)(1) and (2)) five percent or more of the total cost 
                                                               of a qualified facility or carbon capture equipment and 
Section 45Q(f)(9) Election                                     meets other requirements provided in Notice 2020-12, 
For purposes of section 45Q(a)(3) and (4), a person            section 6.
described in section 45Q(f)(3)(A)(ii) may elect, at such           Although both methods can be used, only one method 
time and in such manner as the Secretary may prescribe,        is needed to establish that construction of a qualified 
to have the 12-year period begin on the first day of the first facility or carbon capture equipment has begun. If you 
tax year in which a credit under this section is claimed for   began construction on a qualified facility or carbon 
carbon capture equipment that’s originally placed in           capture equipment by satisfying either the Physical Work 
service at a qualified facility on or after February 9, 2018,  Test or the Five Percent Safe Harbor Test, or both, before 
if:                                                            the effective date of Notice 2020-12 (March 9, 2020), you 
• No one claimed a credit under this section for such          may use March 9, 2020, as the date that construction 
carbon capture equipment for any prior tax year;               began on such qualified facility or carbon capture 
• The qualified facility at which such carbon capture          equipment. Additionally, if you began construction on a 
equipment is placed in service is located in an area           qualified facility or carbon capture equipment before 
affected by a federally declared disaster (as defined by       March 9, 2020, under both the Physical Work Test and the 
section 165(i)(5)(A)) after the carbon capture equipment is    Five Percent Safe Harbor, you may choose either method 
originally placed in service; and                              (but not both) for the purpose of applying the beginning of 
• Such federally declared disaster results in a cessation      construction rules. If you began construction on a qualified 
of the operation of the qualified facility or the carbon       facility or carbon capture equipment on or after March 9, 
                                                               2020, construction will be deemed to have begun on the 

                                                               -6-               Instructions for Form 8933 (Rev. 12-2022)

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date you first satisfy either the Physical Work Test or the        Requirements). Section 45(b)(8)(C) provides that each 
Five Percent Safe Harbor Test. If you fail to satisfy the          taxpayer, contractor, or subcontractor who employs four 
Five Percent Safe Harbor Test in one year due to cost              or more individuals to perform construction, alteration, or 
overruns (as defined in section 6.03 of Notice 2020-12),           repair work for the construction of a qualified facility must 
you won’t be prevented from using the Physical Work Test           employ one or more qualified apprentices to perform such 
in a later year to establish beginning of construction,            work (Apprenticeship Participation Requirements).
provided that occurs before January 1, 2033.
                                                                     See Notice 2022-61 for details.
         To determine your qualification for the section 
         45Q increased credit amounts allowed for                  Recapture
CAUTION! meeting the prevailing wage and apprenticeship 
                                                                   A recapture event occurs when qualified carbon oxide for 
requirements (below), affecting facilities the construction        which a carbon oxide sequestration credit has been 
of which began, or certain property the installation of            claimed ceases to be captured, disposed of, or used as a 
which began, on or after January 30, 2023, see Notice              tertiary injectant during the recapture period. Recapture 
2022-61, 2022-52 I.R.B. 561, available at IRS.gov/irb/             events are determined separately for each project 
2022-52_IRB#NOT-2022-61. Additionally, proposed                    involving capture, disposal, or use of qualified carbon 
regulations and other guidance for the prevailing wage             oxide as a tertiary injectant.
and apprenticeship requirements will be issued later.
                                                                     Qualified carbon oxide ceases to be captured, 
Prevailing Wage Requirements                                       disposed of, or used as a tertiary injectant if the leaked 
                                                                   amount of qualified carbon oxide in the tax year exceeds 
For any qualified facility and any carbon capture 
                                                                   the amount of qualified carbon oxide disposed of in 
equipment placed in service at such facility, you must 
                                                                   secure geological storage or used as a tertiary injectant in 
ensure that any laborers and mechanics employed by you 
                                                                   that same tax year.
or any contractor or subcontractor in (i) the construction of 
such facility or equipment, and (ii) for any tax year, for any       If a recapture event occurs during a project’s recapture 
portion of such tax year that’s within the period described        period and you have claimed a credit for that project, you 
in section 45Q(a)(3)(A) or (4)(A), the alteration or repair of     must report the following information on a Form 8933 filed 
such facility or such equipment, must be paid wages at             with your federal income tax return or Form 1065 for the 
rates not less than the prevailing rates for construction,         tax year for which the recapture event occurred.
alteration, or repair of a similar character in the locality in    • The recapture amount (as defined in Regulations 
which such facility and equipment are located as most              section 1.45Q-5(e));
recently determined by the Secretary of Labor, in                  • The quantity of leaked qualified carbon oxide (in metric 
accordance with subchapter IV of chapter 31 of title 40,           tons) (as defined in Regulations section 1.45Q-5(c));
United States Code. See Notice 2022-61 for details.                • The statutory credit rate at which the credits were 
                                                                   originally calculated; and
For information on how to correct a failure to satisfy the 
prevailing wage requirements, and the penalty related to           • A statement that describes how you became aware of 
                                                                   the recapture event, how the leaked amount was 
the failure, see section 45(b)(7)(B) and Notice 2022-61.
                                                                   determined, and the identity and involvement of any 
Apprenticeship Requirements                                        regulatory agencies.

Section 45(b)(8)(A)(i) provides that to meet the                   Elective Payment of Applicable 
apprenticeship requirements you must ensure that, for the 
construction of any qualified facility, not less than the          Credits
applicable percentage of the total labor hours of the              For tax years beginning after 2022, you can elect under 
construction, alteration, or repair work (including such           section 6417 for your carbon oxide sequestration credit to 
work performed by any contractor or subcontractor) for             be treated as making a payment against the tax imposed 
such facility is, subject to section 45(b)(8)(B), performed        by subtitle A (for the tax year for which the carbon oxide 
by qualified apprentices. Under section 45(b)(8)(A)(ii), for       sequestration credit was determined) equal to the amount 
purposes of section 45(b)(8)(A)(i), the applicable                 of such credit. See section 6417.
percentage is (i) in the case of a qualified facility the 
construction of which begins before January 1, 2023,               Transfer of Carbon Oxide 
10%; (ii) in the case of a qualified facility the construction     Sequestration Credits
of which begins after December 31, 2022, and before 
                                                                   For tax years beginning after 2022, you can elect under 
January 1, 2024, 12.5%; and (iii) in the case of a qualified 
                                                                   section 6418 to transfer all (or any portion specified in the 
facility the construction of which begins after December 
                                                                   election) of your carbon oxide sequestration credits to an 
31, 2023, 15%.
                                                                   unrelated third party (transferee) for cash. The cash 
Section 45(b)(8)(B) provides that the requirement                  payment received by you won’t be treated as taxable 
under section 45(b)(8)(A)(i) is subject to any applicable          income, and the third party transferee can’t deduct the 
requirements for apprentice-to-journeyworker ratios of the         cash payment. Once a carbon oxide sequestration credit 
Department of Labor or the applicable State                        is transferred to a third party under section 6418, the third 
Apprenticeship Agency (Apprenticeship Ratio                        party can’t transfer it again. See section 6418.

Instructions for Form 8933 (Rev. 12-2022)                       -7-

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                                                               state, and EPA e-GGRT ID number(s) (if available) for 
Coordination With Section 142 Bond 
                                                               submission of the facility’s 40 CFR Part 98 (subpart RR) 
Financing                                                      annual reports.
The credit for any project for any tax year is reduced by 
the amount that’s the product of the credit for such tax       Secure Geological Storage
year and the lesser of 15%, or a fraction, the numerator of    Certifications must be made annually.
which is the sum, for the tax year and all prior tax years, of 
the proceeds from an issue described in section 142(a)         Reporting Based on 40 CFR Part 98 (Subpart RR)
(17) used to provide financing for the project the interest 
on which is exempt from tax under section 103, and the         For an EOR or natural gas recovery project in which you 
denominator of which is the aggregate amount of                reported volumes to the EPA pursuant to 40 CFR Part 98 
additions to the capital account for the project for the tax   subpart RR, you may self-certify the volume of carbon 
year and all prior tax years. The amounts under the            oxide claimed for purposes of the credit.
preceding sentence for any tax year are determined as of 
the close of the tax year.                                     Reporting Based on CSA/ANSI ISO 27916:19
Note.    For purposes of the above, there are no prior tax 
                                                               For an EOR or natural gas recovery project in which you 
years before January 1, 2022.
                                                               determined volumes pursuant to CSA/ANSI ISO 
Reporting Requirements                                         27916:19, you may prepare documentation as outlined in 
                                                               CSA/ANSI ISO 27916:19 internally, but such 
General Requirements                                           documentation must be provided to a qualified 
If you’re claiming the carbon oxide sequestration credit,      independent engineer or geologist, who then must certify 
you must provide the name and location of the qualified        that the documentation provided, including the mass 
facilities at which the qualified carbon oxide was captured.   balance calculations as well as information regarding 
                                                               monitoring and containment assurance, is accurate and 
         If you’re claiming the section 45Q credit on an       complete. For any leaked amount of qualified carbon 
         amended federal income tax return, an amended         oxide that’s determined pursuant to CSA/ANSI ISO 
CAUTION! Form 1065, or an AAR, as applicable, you must 
                                                               27916:19, the certification must also include a statement 
state “AMENDED RETURN FOR SECTION 45Q CREDIT”                  that the quantity was determined in accordance with 
at the top of the amended federal income tax return, the       sound engineering principles.
amended Form 1065, or the AAR, as applicable. The 
amended federal income tax return or the amended Form              If you capture qualified carbon oxide giving rise to the 
1065 must be filed, in no event, later than the applicable     credit, you must file Form 8933 with a timely filed federal 
period of limitations on assessment for the tax year for       income tax return or Form 1065, including extensions, or 
which the amended federal income tax return or Form            for the purpose of this rule, amendments to federal 
1065 is being filed.                                           income tax returns, Forms 1065, or on AARs, as 
                                                               applicable. Similarly, if you dispose of, inject, or utilize 
Contractually Ensuring Disposal, Injection, or                 qualified carbon oxide, you must also file Form 8933 with 
Utilization of Qualified Carbon Oxide                          a timely filed federal income tax return or Form 1065, 
If you enter into a contract with another party to ensure      including extensions, or for the purpose of this rule, 
disposal, injection, or utilization of qualified carbon oxide, amendments to federal income tax returns, Forms 1065, 
you must report the existence of each contract, and the        or on AARs, as applicable. If the volume of carbon oxide 
parties involved annually on Form 8933 by each party to        certified and reported is a negative amount, see 
the contract, regardless of the party claiming the credit. In  Regulations section 1.45Q-5 for rules regarding 
addition to any information stated as required on Form         recapture.
8933, the report must include the following information.                    No credit is allowed for any tax year for which you 
• Your name and identifying number;                                         (including credit claimants) have failed to timely 
• The name and taxpayer identification number of each              CAUTION! submit complete documentation, including the 
party with whom you have entered into a contract to            required certifications. The credit will be allowed only for a 
ensure the disposal, injection, or utilization of qualified    tax year for which complete documentation and 
carbon oxide;                                                  certification has been timely submitted. Certifications for 
• The date on which each contract was executed;                each tax year must be submitted by the due date of the 
• The number of metric tons of qualified carbon oxide          federal income tax return or Form 1065 on which the 
each contracting party disposes of, injects, or utilizes on    credit is claimed, including extensions. If a credit is 
behalf of you each tax year for reporting to the IRS; and      claimed on an amended federal income tax return, an 
• For contracts for the disposal of qualified carbon oxide     amended Form 1065, or an AAR, as applicable, 
in secure geological storage or the use of qualified carbon    certifications may also be submitted with such amended 
oxide as a tertiary injectant in EOR or natural gas            federal income tax return, amended Form 1065, or AAR. If 
recovery, identifying information (the name of the             a credit was claimed on a timely filed federal income tax 
operator, field, unit, and reservoir), location by county and  return or Form 1065 for a tax year ending after February 9, 

                                                               -8-            Instructions for Form 8933 (Rev. 12-2022)

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2018, and beginning on or before January 13, 2021, for                Lifecycle greenhouse gas emissions and lifecycle 
which certifications weren’t submitted, such certifications           analysis.   The term “lifecycle greenhouse gas emissions” 
may be submitted with an amended federal income tax                   means the aggregate quantity of greenhouse gas 
return, an amended Form 1065, or an AAR, as applicable,               emissions (including direct emissions and significant 
for the tax year in which the credit was claimed.                     indirect emissions such as significant emissions from land 
                                                                      use changes) related to the full product lifecycle, including 
Qualified EOR or Natural Gas Recovery Project                         all stages of product and feedstock production and 
Each qualified EOR or natural gas recovery project must               distribution, from feedstock generation or extraction 
be certified under Regulations section 1.43-3.                        through the distribution and delivery and use of the 
                                                                      finished product to the ultimate consumer, where the 
For purposes of a natural gas project, a petroleum                    mass values for all greenhouse gases are adjusted to 
engineer's certification as required under Regulations                account for their relative global warming potential 
section 1.43-3(a)(3) and an operator's continued                      according to Table A-1 of 40 CFR Part 98 subpart A. The 
certification of a project as required under Regulations              amount of lifecycle greenhouse gas emissions measured 
section 1.43-3(b)(3) must include an additional statement             by a lifecycle greenhouse gas analysis (LCA) is 
that the certification is for purposes of the credit.                 expressed in carbon dioxide equivalents (CO2-e).
                                                                      Measurement.    The measurement and written LCA report 
Petroleum Engineer’s Certification                                    must be performed by or verified by an independent third 
                                                                      party. The LCA report must be prepared in conformance 
The petroleum engineer's certification must be attached to            with, and contain documentation that conforms to, the 
a Form 8933 and filed no later than the last date                     International Organization for Standardization (ISO) 
prescribed by law (including extensions) for filing the               14040:2006, Environmental Management—Life Cycle 
operator's or designated owner's federal income tax return            Assessment—Principles and Framework and ISO 
or Form 1065 for the first tax year in which qualified                14044:2006, Environmental Management—Life Cycle 
carbon oxide is injected into the reservoir.                          Assessment—Requirements and Guidelines, as well as a 
         If a credit is claimed on an amended federal                 statement documenting the qualifications of the 
         income tax return, an amended Form 1065, or an               independent third party, including proof of appropriate 
CAUTION! AAR, as applicable, the petroleum engineer's                 U.S. or foreign professional license, and an affidavit from 
certification will be treated as filed timely if it is attached to    the third party stating that it's independent from you.
a Form 8933 that’s submitted with such amended federal                Approval of the LCA. You must submit the written LCA 
income tax return, amended Form 1065, or AAR. For a                   report and independent third-party statement to the IRS 
credit that’s claimed on a timely filed federal income tax            and the Department of Energy (DOE). The LCA will be 
return or Form 1065 for a tax year ending after February 9,           subject to a technical review by the DOE, and the IRS will 
2018, and beginning on or before January 13, 2021, for                determine whether to approve the LCA.
which the petroleum engineer's certification wasn’t 
                                                                      You should fax a copy of your LCA report, including the 
submitted, the petroleum engineer's certification will be 
                                                                      independent third-party statement specified in 
treated as filed timely if it is attached to an amended Form 
                                                                      Regulations section 1.45Q-4(c)(4), to the IRS at 
8933 for any tax year ending after February 9, 2018, but 
                                                                      844-255-4817. The submission should include a cover 
not for tax years beginning on or before January 13, 2021.
                                                                      letter with:
                                                                      1. Name of the facility where the qualified carbon 
Operator’s Continued Certification                                    oxide is utilized (“utilization facility”);
                                                                      2. Name of the operator of the utilization facility, 
The operator's continued certification of a project must be           including operator’s TIN/EIN;
attached to a Form 8933 and filed no later than the last 
date prescribed by law (including extensions) for filing the          3. Name of the taxpayer(s) claiming the credit based 
operator's or designated owner's federal income tax return            on the LCA, including each taxpayer's TIN/EIN;
or Form 1065 for tax years after the tax year for which the           4. Name of a corporate officer in charge of the LCA 
petroleum engineer's certification is filed but not after the         report submission (or a designated representative) with a 
tax year in which injection activity ceases and all injection         written power of attorney (POA on Form 2848) and that 
wells are plugged and abandoned.                                      person's contact information, including official corporate 
                                                                      mailing address;
Utilization                                                           5. Tax year in which the credit is claimed; and
The amount of qualified carbon oxide utilized by you is 
                                                                      6. Reserved for future use.
equal to the metric tons of qualified carbon oxide that you 
demonstrate, based upon an analysis of lifecycle                      You should also mail (1) the items above, and (2) the 
greenhouse gas emissions (LCA), that were captured and                model, if the LCA wasn’t verified by an independent 
permanently isolated from the atmosphere (isolated), or               third-party review, on a USB thumb drive, to:
displaced from being emitted into the atmosphere 
(displaced).

Instructions for Form 8933 (Rev. 12-2022)                          -9-

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Internal Revenue Service
Part II. Facilities at Which Qualified
Office of Associate Chief Counsel (PSI)
1111 Constitution Ave. NW Carbon Oxide Qualifies for a Credit
Branch 6 (CC:PSI:6), Room 5114
Under Section 45Q(a)(1) or (2), or for
Washington, DC 20224
Which an Election Was Made Under
You should also send the DOE an email at
Section 45Q(b)(3)
LCA45Q@hq.doe.gov, and the DOE will respond with
instructions for submitting the LCA application to the DOE. Line 1a
Enter the number of metric tons of qualified carbon oxide
Specific Instructions captured using carbon capture equipment originally
placed in service at a qualified facility before February 9,
To claim the credit for disposal of carbon oxide in secure 2018 (or, on or after February 9, 2018, for facilities for
geological storage or for use of carbon oxide as a tertiary which an election was made under section 45Q(b)(3); see
injectant in an EOR or natural gas recovery project, prior Line 10. Section 45Q(b)(3) Election, later), disposed of in
to disposal in secure geological sequestration, the amount secure geological storage, and not used as a tertiary
of carbon oxide must be measured at the source of injectant in a qualified enhanced oil or natural gas
capture and verified either at the point of disposal in recovery project, or utilized in a way described in section
secure geological storage or at the point of injection as a 45Q(f)(5).
tertiary injectant in an EOR or natural gas recovery
project. The amount of qualified carbon oxide is presumed Line 1b
to be the lesser of the amount measured at capture and Enter inflation-adjusted credit rate. See 2022 credit rates
the amount verified at disposal or injection unless it can and applicable dollar amounts, earlier.
be established to the satisfaction of the IRS that the
greater amount is the correct amount. Line 2a
To claim the credit for utilization of carbon oxide, the Enter the number of metric tons of qualified carbon oxide
amount of qualified carbon oxide utilized by you is equal captured using carbon capture equipment originally
to the metric tons of qualified carbon oxide that you placed in service at a qualified facility before February 9,
demonstrate, based upon an analysis of lifecycle 2018 (or, on or after February 9, 2018, for facilities for
greenhouse gas emissions (LCA), were (1) captured and which an election was made under section 45Q(b)(3); see
permanently isolated from the atmosphere, or (2) Line 10. Section 45Q(b)(3) Election, later), disposed of in
displaced from being emitted into the atmosphere. The secure geological storage, and used as a tertiary injectant
amount of qualified carbon oxide utilized by you for in a qualified enhanced oil or natural gas recovery project.
purposes of the carbon oxide sequestration credit can't
exceed the amount of qualified carbon oxide measured at Line 2b
the source of capture. Enter inflation-adjusted credit rate. See 2022 credit rates
and applicable dollar amounts, earlier.
Part I. Information About You
Check the applicable box(es). Line 3a
Enter the number of metric tons of qualified carbon oxide
Box 1. Check box 1 if you captured qualified carbon
captured using carbon capture equipment originally
oxide during the tax year.
placed in service at a qualified facility before February 9,
Box 2. Check box 2 if you physically disposed, used, or 2018 (or, on or after February 9, 2018, for facilities for
utilized captured qualified carbon oxide during the tax which an election was made under section 45Q(b)(3); see
year. Line 10. Section 45Q(b)(3) Election, later), and utilized as
Box 3. Check box 3 if you elected to allow another described in section 45Q(f)(5).
person to claim the carbon oxide sequestration credit that
Line 3b
you would’ve otherwise been entitled to claim. See
Section 45Q(f)(3)(B) Election, earlier Enter inflation-adjusted credit rate. See 2022 credit rates
and applicable dollar amounts, earlier.
Box 4. Check box 4 if another person elected to allow
you to claim the carbon oxide sequestration credit that
they would’ve otherwise been entitled to claim. See
Section 45Q(f)(3)(B) Election, earlier

-10- Instructions for Form 8933 (Rev. 12-2022)

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                                                               or natural gas recovery project, nor utilized as described 
Part III. Qualified Facilities Under 
                                                               in section 45Q(f)(5).
Section 45Q(a)(3) or (4) for Which No 
                                                               Line 7b
Election Was Made Under Section 
                                                               Enter $36 for the section 45Q(b)(1)(B)(i) applicable dollar 
45Q(b)(3)                                                      amount ($180 if section 45Q(h)(2) requirements are met).

Line 4a                                                        Line 8a
Enter the number of metric tons of qualified carbon oxide      Qualified carbon oxide captured using carbon capture 
captured using carbon capture equipment originally             equipment originally placed in service at a qualified direct 
placed in service at a qualified facility on or after February air capture facility after 2022, during the 12-year period 
9, 2018, during the 12-year period beginning on the date       beginning on the date the equipment was originally placed 
the equipment was originally placed in service, disposed       in service, disposed of in secure geological storage, and 
of in secure geological storage, and not used as a tertiary    used as a tertiary injectant in a qualified enhanced oil or 
injectant in a qualified enhanced oil or natural gas           natural gas recovery project.
recovery project, nor utilized as described in section 
45Q(f)(5).                                                     Line 8b
                                                               Enter $26 for the section 45Q(b)(1)(B)(ii) applicable dollar 
Line 4b                                                        amount ($130 if section 45Q(h)(2) requirements are met).
Enter section 45Q(a)(3) applicable dollar amount. See 
2022 credit rates and applicable dollar amounts, earlier.      Line 9a
                                                               Qualified carbon oxide captured using carbon capture 
Line 5a                                                        equipment originally placed in service at a qualified direct 
Enter the number of metric tons of qualified carbon oxide      air capture facility after 2022, during the 12-year period 
captured using carbon capture equipment originally             beginning on the date the equipment was originally placed 
placed in service at a qualified facility on or after February in service and utilized as described in section 45Q(f)(5).
9, 2018, during the 12-year period beginning on the date 
the equipment was originally placed in service, disposed       Line 9b
of in secure geological storage, and used as a tertiary        Enter $26 for the section 45Q(b)(1)(B)(ii) applicable dollar 
injectant in a qualified enhanced oil or natural gas           amount ($130 if section 45Q(h)(2) requirements are met).
recovery project.
                                                               Part V. Other Information
Line 5b
Enter section 45Q(a)(4) applicable dollar amount. See          Line 10. Section 45Q(b)(3) Election
2022 credit rates and applicable dollar amounts, earlier.      You may check the box to elect having the dollar amounts 
                                                               applicable under section 45Q(a)(1) or (2) apply in lieu of 
Line 6a                                                        the dollar amounts applicable under section 45Q(a)(3) or 
Enter the number of metric tons of qualified carbon oxide      (4) for each metric ton of qualified carbon oxide that’s 
captured using carbon capture equipment originally             captured by you using carbon capture equipment that’s 
placed in service at a qualified facility on or after February originally placed in service at a qualified facility on or after 
9, 2018, during the 12-year period beginning on the date       February 9, 2018. See the instructions for lines 1a, 2a, or 
the equipment was originally placed in service, and            3a, earlier.
utilized as described in section 45Q(f)(5).
                                                               Line 11. Section 45Q(f)(6) Election
Line 6b                                                        You may check the box to elect for applicable facilities 
Enter section 45Q(a)(4) applicable dollar amount. See          under section 45Q(f)(6)(A). Section 45Q(f)(6)(A) provides 
2022 credit rates and applicable dollar amounts, earlier.      that for any tax year in which an applicable facility 
                                                               captures not less than 500,000 metric tons of qualified 
Part IV. Qualified Direct Air Capture                          carbon oxide, the person described in section 45Q(f)(3)
                                                               (A)(ii) may elect to have such applicable facility, and any 
Facilities Under Section 45Q(d)(2)(A) 
                                                               carbon capture equipment placed in service at such 
Placed in Service After 2022                                   applicable facility, deemed as having been placed in 
                                                               service on February 9, 2018. The term “applicable facility” 
Line 7a                                                        means a qualified facility (i) that was placed in service 
Qualified carbon oxide captured using carbon capture           before February 9, 2018, and (ii) for which no taxpayer 
equipment originally placed in service at a qualified direct   claimed a carbon oxide sequestration credit in regards to 
air capture facility after 2022, during the 12-year period     such facility for any tax year ending before February 9, 
beginning on the date the equipment was originally placed      2018.
in service, disposed of in secure geological storage, and 
not used as a tertiary injectant in a qualified enhanced oil 

Instructions for Form 8933 (Rev. 12-2022)                      -11-

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Line 12. Section 45Q(f)(9) Election Line 16
You may check the box to elect to have the 12-year period Enter the carbon oxide sequestration credit recaptured.
begin on the first day of the first tax year in which a credit Attach a statement substantially similar to Model
under section 45Q is claimed for carbon capture Certificate(s) RECAPTURE to Form 8933. Report the
equipment that’s originally placed in service at a qualified credit recapture amount on the appropriate line of your
facility on or after February 9, 2018, if you own the carbon return.
capture equipment and physically or contractually ensure
the capture and disposal, utilization, or use as a tertiary Model Certificates
injectant of such qualified carbon oxide; and if (i) no one Per the TD and the NPRM that preceded it, if you’re a
claimed a credit under this section for such carbon large section 45Q project filer, you’ll likely have to use
capture equipment for any prior tax year, (ii) the qualified multiple legal contracts with multiple parties for the
facility at which such carbon capture equipment is placed capture, utilization, or disposal of carbon oxides and,
in service is located in an area affected by a federally generally to claim the credit, the existence of each
declared disaster (as defined by section 165(i)(5)(A)) after contract and the parties involved must be reported on
the carbon capture equipment is originally placed in Form 8933 annually. For this reporting, filers should use
service, and (iii) such federally declared disaster results in attachments substantially similar to model certificates
a cessation of the operation of the qualified facility or the shown below.
carbon capture equipment after such equipment is Model Certificate CF. Use Model Certificate CF if you’re
originally placed in service. the owner of a capture facility (may not be the same entity
as the owner of the industrial facility) that emits carbon
Line 13. Section 45Q(f)(3)(B) Election
oxide. Model Certificate CF will help show your share of
If you checked box 4 in Part I, complete line 13 with the carbon oxide sequestration credit.
information reported to you on a statement substantially
similar to Model Certificate(s) ELECT by the electing Model Certificate DISP-Operator. Use Model
person(s). See Section 45Q(f)(3)(B) Election, earlier. Certificate DISP-Operator if you’re the operator (or
designated operator) of a geologic disposal site at which
Lines 13a, 13b, and 13c. Complete lines 13a, 13b, and captured qualified carbon oxide was injected during the
13c with basic information reported to you on a statement calendar year. Don’t use this model certificate if carbon
substantially similar to Model Certificate(s) ELECT by the oxide was injected for enhanced oil or natural gas
electing person(s), for the three largest elections (in recovery. Provide a copy of your signed Model Certificate
dollars). DISP-Operator to each owner of the disposal site project.
(i) EIN of electing taxpayer.
Model Certificate DISP-Owner. Use Model Certificate
(ii) Metric tons elected.
DISP-Owner if you’re the owner (or one of the owners) of
(iii) Credit rates.
the geologic disposal site at which captured carbon oxide
(iv) Credit elected.
was injected during the calendar year. The operator of the
Line 13e. Report all other carbon oxide sequestration disposal site prepares Table 3 of Model Certificate
credit that another person elected under section 45Q(f)(3) DISP-Operator. Report the amounts from that Table 3 on
(B) to allow you to claim. Subtract line 13d from the total lines 11, 12, and 14 through 16.
carbon oxide sequestration credit reported to you on a
Model Certificate EOR-Operator. Use Model Certificate
statement substantially similar to Model Certificate(s)
EOR-Operator if you’re the operator (or designated
ELECT, Part II, line 6; enter amount on line 13e.
operator) of an enhanced oil or gas recovery project (EOR
Complete a statement substantially similar to project) at which captured qualified carbon oxide was
TIP Model Certificate ELECT if you elect under injected during the calendar year. Provide a copy of your
section 45Q(f)(3)(B) to allow another person to signed Model Certificate EOR-Operator to each owner of
claim carbon oxide sequestration credit. See Model the EOR project.
Certificate ELECT, later.
Model Certificate EOR-Owner. Use Model Certificate
EOR-Owner if you’re the owner (or one of the owners) of
Line 14 the EOR project at which captured carbon oxide was
Enter the total qualified carbon oxide sequestration credits injected during the calendar year. The operator of the
from: EOR project prepares Table 3 of Model Certificate
• Schedule K-1 (Form 1065), Partner's Share of Income, EOR-Operator. Report the amounts from that Table 3 on
Deductions, Credits, etc., box 15 (code P); and lines 11, 12, and 14 through 16.
• Schedule K-1 (Form 1120-S), Shareholder's Share of
Model Certificate UTZ. Use Model Certificate UTZ if
Income, Deductions, Credits, etc., box 13 (code P).
you’re the owner of the utilization facility who utilized
Partnerships and S corporations report the above qualified carbon oxide during the calendar year. Don’t
credits on line 10 and their Schedule K. All others not combine information from separate utilization facilities on
using earlier lines to figure a separate credit can report the the same Model Certificate UTZ. Provide a copy of your
above credits directly on Form 3800, Part III, line 1x. signed Model Certificate UTZ to each supplier that

-12- Instructions for Form 8933 (Rev. 12-2022)

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supplied qualified captured carbon oxide to inform the        (2) you elect under section 45Q(f)(3)(B) to allow the 
suppliers of the amount of their qualified carbon oxide that  carbon oxide sequestration credit to that person. You 
was utilized.                                                 must make a separate election for each qualified facility.
Model Certificate ELECT. Use Model Certificate ELECT          Model Certificate RECAPTURE. Use Model Certificate 
if (1) you’re the owner of the capture facility that supplied RECAPTURE if you’re the operator or owner of the 
qualified carbon oxide to another person that was properly    geologic disposal site or EOR project to report a recapture 
disposed of in geological storage, used in an EOR project,    event.
or utilized in a manner consistent with section 45Q(f), and 

Instructions for Form 8933 (Rev. 12-2022)                     -13-

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                                                                    Model Certificate CF
                                                          Capture Facility Certification                                                                         2022
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)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      
3   Facility's EPA e-GGRT ID number(s)*         . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      
4   Is the facility an electricity-generating facility? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5   Is the facility a direct air capture facility? If “Yes,” skip to line 12    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6   If the facility isn’t an electricity-generating or direct air capture 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 carbon oxide sequestration 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 qualified 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 direct air capture facility information:
12  Is carbon capture done by a direct air capture facility?          . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13  State the location of the carbon capture equipment or direct air capture facility (county 
    and state) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     
14  Was any carbon capture equipment placed in service prior to February 9, 2018? See instructions                          . . . . . . . . . . . . . . . . . .
15  What was the placed-in-service date (MM/DD/YYYY) of the carbon capture equipment or 
    direct air capture facility described on line 13? See instructions . . . . . . . . . . . . . . .               
16  Are you the owner of the carbon capture equipment described on line 13?                   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16a If you answered “No” to line 16, state your basis for claiming the credit             . . . . . . . . . .      
17  For carbon capture 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 carbon oxide sequestration credit for carbon oxide captured by each single train of carbon capture 
    equipment during the tax year (irrespective of any election you make to allow a contracting disposer, injector, or utilizer to claim 
    credit)? Don’t claim the credit unless you can answer “Yes.” See instructions                 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18  For the carbon capture equipment described on line 13, what was the carbon capture 
    capacity on or after February 8, 2018?        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      
* if available
                                                                                                                                                            Model Certificate CF

                                                                                  -14-                              Instructions for Form 8933 (Rev. 12-2022)

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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 carbon capture 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 carbon capture 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 carbon capture 
    equipment and the fair market value of pre-existing carbon capture equipment                     . . .      
19e If the placed-in-service date of the carbon capture equipment was determined pursuant to the 80/20 rule, did you include its 
    investment in a transportation pipeline as new carbon capture 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 carbon oxide 
    sequestration 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, 2, or 3 in Part II.
26  If you answered “No” to line 24, determine the credit using lines 4, 5, or 6 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 4, 5, or 6 in Part III. See instructions.
Part II. Facilities at Which Qualified Carbon Oxide Qualifies for a Credit Under Section 45Q(a)(1) or (2), or 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 before February 9, 2018 (or, on or 
after February 9, 2018, for facilities for which an election was made under section 45Q(b)(3)), 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 delivered to 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                      $25.07
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.                                                $25.07
    Attach Model Certificate ELECT for each disposal site              . . . . . . . . . . . . . . . . . .
1f  Your carbon oxide sequestration credit. Subtract line 1e from line 1d. . . . . . . . . .                                                 $25.07
                                                                                                                                                             Model Certificate CF

Instructions for Form 8933 (Rev. 12-2022)                                            -15-

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                                                                                                                                        Page 3
Part II. Facilities at Which Qualified Carbon Oxide Qualifies for a Credit Under Section 45Q(a)(1) or (2), or 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 before February 9, 2018, 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 delivered to point of injection             . . . . . . . . . . . . . . . . . .
2b Metric tons captured and securely stored by you. Attach Model Certificates 
   EOR-Operator and EOR-Owner for each recovery project                     . . . . . . . . . . . . . . . .
2c Metric tons captured and securely stored by another person. Attach Model Certificates 
   EOR-Operator and EOR-Owner for each recovery project                     . . . . . . . . . . . . . . . .
2d Add lines 2b and 2c      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $12.53
2e Metric tons captured and securely stored by another person and for which you allow 
   that person to claim the resulting carbon oxide sequestration credit. Attach Model                                        $12.53
   Certificate ELECT for each recovery project            . . . . . . . . . . . . . . . . . . . . . . . . .
2f Your carbon oxide sequestration credit. Subtract line 2e from line 2d. . . . . . . . . .                                  $12.53
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility before February 9, 2018, 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 delivered to 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      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $12.53
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 as carbon dioxide equivalents that were determined pursuant to an                                               $12.53
   approved LCA. See instructions. Attach Model Certificate ELECT for each utilization 
   facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3f Your carbon oxide sequestration credit. Subtract line 3e from line 3d. . . . . . . . . .                                  $12.53
                                                                                                                                     Model Certificate CF

                                                                                      -16-                   Instructions for Form 8933 (Rev. 12-2022)

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                                                                                                                                                  Page 4
Part III. 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, 
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).
4a Metric tons captured and delivered to 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   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $37.85
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.                                     $37.85
   Attach Model Certificate ELECT for each disposal site. . . . . . . . . . . . . . . . . . .
4f Your carbon oxide sequestration credit. Subtract line 4e from line 4d             . . . . . . . . . .                  $37.85
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9, 2018, 
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).
5a Metric tons captured and delivered to point of injection          . . . . . . . . . . . . . . . . . .
5b Metric tons captured and securely stored (physically disposed) by you. Attach Model 
   Certificates EOR-Operator and EOR-Owner for each recovery project                   . . . . . . . . .
5c Metric tons captured and securely stored (physically disposed) by another person. 
   Attach Model Certificates EOR-Operator and EOR-Owner for each recovery 
   project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5d Add lines 5b and 5c   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $25.15
5e 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.                                     $25.15
   Attach Model Certificate ELECT for each recovery project              . . . . . . . . . . . . . . . .
5f Your carbon oxide sequestration credit. Subtract line 5e from line 5d             . . . . . . . . . .                  $25.15
                                                                                                                                  Model Certificate CF

Instructions for Form 8933 (Rev. 12-2022)                                          -17-

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                                                                                                                                                  Page 5
Part III. 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, 
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).
6a  Metric tons captured and delivered to 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 . . . . . . . . . . . .
6c  Metric tons captured and physically utilized by another person. Attach Model 
    Certificate UTZ for each utilization facility. Expressed as carbon dioxide 
    equivalents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6d  Add lines 6b and 6c   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $25.15
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. 
                                                                                                                           $25.15
    Expressed as carbon dioxide equivalents. Attach Model Certificate ELECT for each 
    utilization project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6f  Your carbon oxide sequestration credit. Subtract line 6e from line 6d. . . . . . . . . .                               $25.15
Part IV. Qualified Direct Air Capture Facilities Under Section 45Q(d) Placed in Service After 2022
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified direct air capture 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).
7a  Metric tons captured and delivered to 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  Sum of 7b and 7c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                    $36
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.                                     $36
    Attach Model Certificate ELECT for each disposal site           . . . . . . . . . . . . . . . . . . .
7f  Your carbon oxide sequestration credit. Subtract line 7e from line 7d. . . . . . . . . .                               $36
Note. Enter $180 in column (b) for lines 7d, 7e, and 7f if section 45Q(h)(2) requirements are met.
                                                                                                                                   Model Certificate CF

                                                                                    -18-                   Instructions for Form 8933 (Rev. 12-2022)

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                                                                                                                                        Page 6
Part IV. Qualified Direct Air Capture Facilities Under Section 45Q(d) Placed in Service After 2022 (continued)
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified direct air capture 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).
8a  Metric tons captured and delivered to point of injection          . . . . . . . . . . . . . . . . . .
8b  Metric tons captured and securely stored (physically disposed) by you. Attach Model 
    Certificates EOR-Operator and EOR-Owner for each recovery project                   . . . . . . . . .
8c  Metric tons captured and securely stored (physically disposed) by another person. 
    Attach Model Certificates EOR-Operator and EOR-Owner for each recovery 
    project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8d  Add lines 8b and 8c   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  $26
8e  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.                                     $26
    Attach Model Certificate ELECT for each recovery project              . . . . . . . . . . . . . . . .
8f  Your carbon oxide sequestration credit. Subtract line 8e from line 8d. . . . . . . . . .                               $26
Note. Enter $130 in column (b) for lines 8d, 8e, and 8f if section 45Q(h)(2) requirements are met.
Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified direct air capture 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).
9a  Metric tons captured and delivered to 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 . . . . . . . . . . . .
9c  Metric tons captured and physically utilized by another person. Attach Model 
    Certificate UTZ for each utilization facility. Expressed as carbon dioxide 
    equivalents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9d  Sum of 9b and 9c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                    $26
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. 
                                                                                                                           $26
    Expressed as carbon dioxide equivalents. Attach Model Certificate ELECT for each 
    utilization project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9f  Your carbon oxide sequestration credit. Subtract line 9e from line 9d. . . . . . . . . .                               $26
Note. Enter $130 in column (b) for lines 9d, 9e, and 9f if section 45Q(h)(2) requirements are met.
                                                                                                                                   Model Certificate CF

Instructions for Form 8933 (Rev. 12-2022)                                           -19-

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                                                                                                                         Page 7
                                                   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

                                                   -20-                                      Instructions for Form 8933 (Rev. 12-2022)

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Model Certificate DISP-Operator

Disposal Operator Certification 2022
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 are 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
Operating
Disposal site owner Name Address EIN 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 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 qualified 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 of supplied any
Qualified carbon
Name EIN capture facility EPA's e-GGRT ID* nonqualified
oxide supplier
(county, state) carbon oxide from
any source
1
2
3
* if available
Model Certificate DISP Operator‐

Instructions for Form 8933 (Rev. 12-2022) -21-

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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 are 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 of nonqualified carbon oxide suppliers
number 1 number 2 number 3 all suppliers carbon oxide
(H)
(I) Metric
Metric (L) Metric
(C) tons (M) Metric
(A) (B) (D) (E) (F) (G) tons (J) (K) tons
Metric stored tons stored
Geologic Metric Metric Metric Metric Metric delivered Metric Metric delivered
tons (add (add
disposal tons tons tons tons tons (add tons tons (add
store columns columns (I)
site owner delivered delivered stored delivered stored columns delivered stored columns
d (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‐

-22- Instructions for Form 8933 (Rev. 12-2022)

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                                                               Model Certificate DISP Owner‐

                                                                     Disposal Owner Certification                                                             2022
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 qualified 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    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. 12-2022)                                              -23-

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                                                         Model Certificate EOR Operator‐

                                           Enhanced Oil Recovery Operator Certification                                                               2022
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 are 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         
5  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 carbon oxide sequestration 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 qualified 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‐

                                                                                 -24-                              Instructions for Form 8933 (Rev. 12-2022)

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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 provided 
                                                                         Name of 
     carbon oxide             Name                          EIN                                     facility provided any qualified      any 
                                                                   capture facility
        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 are 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. 12-2022)                          -25-

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                                                             Model Certificate EOR Owner‐

                                                         Enhanced Oil Recovery Owner Certification                                                          2022
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‐

                                                                                   -26-                              Instructions for Form 8933 (Rev. 12-2022)

- 27 -

Page 27 of 38     Fileid: … ns/i8933/202212/a/xml/cycle06/source                                                                         12:51 - 5-Jan-2023

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

                                                                   Model Certificate UTZ

                                                            Utilization Certification                                                                             2022
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 qualified 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 qualified carbon oxide utilization facility during the calendar year. If there are 
    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. 12-2022)                                          -27-

- 28 -

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

      Page 2
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             (K))
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     carbon oxide                 utilized (add 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     (M) Metric tons of                                                                        columns (I) and 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Model Certificate UTZ
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       and (J))
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  nonqualified carbon oxide                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               of carbon                                                    to utilization               facility (add                 columns (H) 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Check if supplier supplied any                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Sum for all carbon oxide suppliers                                     (L) Metric tons                                                 oxide delivered 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              EPA                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               tons of                                                   utilized
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  (K) Metric 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         e-GGRT ID                                          number(s)*                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               .                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           carbon oxide 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     .

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     oxide                                                                                facility
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Location of                                                                                   (county, state)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          (J) Metric tons                                                                             delivered to                  utilization 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 Total nonqualified carbon                                       oxide from all suppliers                                                               of carbon 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         capture facility 

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

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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        tons of 

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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     tons of 
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            1 2 3                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Name of qualified carbon                                                                                                                                                                         carbon oxide                 delivered to                  utilization 

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  supplier
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   1 2 3  4
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               facility                                                                    Total
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Qualified carbon oxide                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     lessee of                   utilization 
                                                                                                                                                                                                                                                                                                          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 qualified 45Q facilities. “Supplier” means the person who captured the qualified carbon oxide, which may differ from the company that sold the carbon oxide or physically                                                                                                                                                                                                                  delivered the carbon oxide to the owner of the utilization facility. If there are more than three suppliers of qualified carbon oxide 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 are 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 Qualified Carbon Utilization Facility and Utilization of Carbon Oxide                                                                                              Section 2—Information about the qualified carbon oxide supplied to the utilization facility:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          10                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           * if available

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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
                                                                                                                                                                                                                                                                                                                                                                                                                                                1                                                            2                                                  3                                         4                                                                                        5                                                                                             6
                                                                                                    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. 12-2022)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        -29-

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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 qualified 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

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    -30-                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Instructions for Form 8933 (Rev. 12-2022)

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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. 12-2022)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       -31-

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                                                                    Model Certificate ELECT

                                                                  Election Certification                                                                         2022
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  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
7  EPA e-GGRT ID number(s)* of each qualified 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            . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
14 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 qualified facility before February 9, 
              2018, 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 qualified facility before February 9, 
              2018, 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 qualified facility before February 9, 
              2018, and utilized as described in section 45Q(f)(5).
   d          Qualified carbon oxide captured using carbon capture equipment originally placed in service at a qualified facility on or after February 9, 
              2018, 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 qualified facility on or after February 9, 
              2018, 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 qualified facility on or after February 9, 
              2018, 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.
17 Check the correct credit rate that applies for 2022 based on the boxes checked for lines 12, 15, and 16.
   a          $25.07 ($20 plus inflation for old equipment)
   b          $12.53 ($10 plus inflation for old equipment)
   c          $37.85 for new equipment and qualified carbon oxide disposed of in secure storage and not used in EOR
   d          $25.15 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)

* if available
                                                                                                                                                        Model Certificate ELECT

                                                                                      -32-                              Instructions for Form 8933 (Rev. 12-2022)

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                                                                                                                                                   Page 2
                                                                   Election Certification (continued)
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 II, column (a) of line 1e, 2e, or 3e, or Part III, column (a) of line 4e, 
     5e, or 6e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
5    2022 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 13 . . . . . . . . . . . . . . .                  
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 . . . . . .                     

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

Instructions for Form 8933 (Rev. 12-2022)                                              -33-

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                                                           Model Certificate RECAPTURE

                                                           Recapture Certification                                                                          2022
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
                                 2022                                    2021                                      2020                                 2019
                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 2022:
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)   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    
6     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

                                                                                 -34-                              Instructions for Form 8933 (Rev. 12-2022)

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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 
   2022. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   
2  Metric tons of qualified carbon oxide that, during 2022, the owner, operator, or regulatory agency determined has leaked 
   from the containment area of the reservoir during 2022 or previous calendar years if not previously accounted for                           . . . . .     
3  Metric tons of qualified carbon oxide that, during 2022, the owner, operator, or regulatory agency determined has leaked 
   from the containment area of the reservoir during 2022 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                         carbon 
               Year                      subject to 
   prior                 of the                          oxide 
                                         recapture*
                       applicable                        was 
                        Operator                         qualified                                                                        
                       Certificate                       carbon 
                          for the                        oxide
                       indicated 
                           year
   (1) 1st   2021
   (2) 2nd   2020
   (3) 3rd   2019
   (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

Instructions for Form 8933 (Rev. 12-2022)                                            -35-

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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

                                                                                       -36-                              Instructions for Form 8933 (Rev. 12-2022)

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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    2021
     (2) 2nd    2020
     (3) 3rd    2019
     (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 V, 
         line 16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
     (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 V, line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

Instructions for Form 8933 (Rev. 12-2022)                                             -37-

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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.

                                                                                 -38-                              Instructions for Form 8933 (Rev. 12-2022)

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