Page 108 - IRS Business Tax Credits Guide

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The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.
Page 3 No Fileid: … ns/i8933/202212/a/xml/cycle06/source 12:51 - 5-Jan-2023

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Model Certificate UTZ

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?

Part I. Information About the Qualified Carbon Utilization Facility and Utilization of Carbon Oxide (continued)

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Part II. Information About the Life Cycle Assessment (LCA) and This Claim
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Title of the LCA submitted to the Department of Energy (DOE)
Project or LCA number assigned by the DOE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date (MM/DD/YYYY) the LCA was submitted to 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

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Instructions for Form 8933 (Rev. 12-2022) -29-