Page 116 - IRS Business Tax Credits Guide

12:51 - 5-Jan-2023
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Fileid: … ns/i8933/202212/a/xml/cycle06/source
The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.
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
carbon oxide
sequestration of carbon oxide sequestration
for which the
(C) Total (E) Your (G) Metric tons of credit for supplier didn’t credit for which
which the
carbon oxide for
metric (D) Total amount of (F) Rate of which the supplier elect to allow the supplier
(A) tons of metric tons of qualified carbon oxide supplier elected elected to you to claim didn’t elect to
(B)
stored
Year Year carbon stored carbon carbon sequestration to allow you to allow you to the carbon allow you to
oxide
claim the
prior oxide oxide subject oxide credit for the claim the carbon claim the sequestration carbon oxide
from to recapture subject to year ($/MT) oxide carbon oxide credit (MT). sequestration
Table 2 recapture sequestration sequestration Subtract credit ($).
credit ($).
credit (MT)
Multiply column (G) Multiply
column (G) from column column (I) by
(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-