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Number range CHAPTER*The Acid Rain Program, CAIR Trading Programs (CAIR
NO~X~ Annual, CAIR SO~2~, and CAIR NO~X~ Ozone Season), and CAMR Trading
Program regulations require any person, company, or organization wishing
to open a general account for the purpose of holding and transferring
allowances to submit a completed General Account form. You also may use
this form to change the information previously submitted for a general
account, such as the identity of the authorized account representative.
In such cases, enter your allowance account identification number in the
space provided at the top of the form. Note: A compliance account can
only be established, and information concerning a compliance account can
only be changed, by submitting a Certificate of Representation form.*

If you need assistance, call the Clean Air Markets Hotline at
202-343-9620.

**STEP 2** The owners may choose an alternate to act on behalf of the
Authorized Account Representative.

**STEP 3** Identify all parties with an ownership interest in the
allowances held in this account. All of these parties must be subject to
a binding agreement authorizing the representation of the account by the
authorized account representative, and, if applicable, the alternate
authorized account representative, identified in Steps 1 and 2. If you
(the authorized account representative) are the only person with an
ownership interest in the allowances held in the account, list your name
here. If additional space is needed, please attach a separate sheet of
paper.

**STEP 4** If you are establishing a general account, both the
authorized account representative and the alternate (if any) must sign
and date the certifications. You are encouraged to use the CAMD Business
System (CBS) to submit general account information online. To register
for CBS, go to https://camd.epa.gov/loginrequest/index.cfm.

For more information see the applicable rule:

> Acid Rain: 40 CFR 73.31
>
> CAIR NO~X~ Annual: 40 CFR 96.151 or 97.151 or the applicable State
> rule
>
> CAIR SO~2~: 40 CFR 96.251 or 97.251 or the applicable State rule
>
> CAIR NO~X~ Ozone Season: 40 CFR 96.351 or 97.351 or the applicable
> State rule
>
> CAMR: 40 CFR 60.4151 or the applicable State rule

**Paperwork Burden Estimate**

The public reporting and recordkeeping burden for this collection of
information is estimated to average 10 hours per response. Burden means
the total time, effort, or financial resources expended by persons to
generate, maintain, retain, or disclose or provide information to or for
a Federal agency. This includes the time needed to review instructions;
develop, acquire, install, and utilize technology and systems for the
purposes of collecting, validating, and verifying information,
processing and maintaining information, and disclosing and providing
information; adjust the existing ways to comply with any previously
applicable instructions and requirements; train personnel to be able to
respond to a collection of information; search data sources; complete
and review the collection of information; and transmit or otherwise
disclose the information. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information unless
it displays a currently valid OMB control number.

Send comments on the Agency's need for this information, the accuracy of
the provided burden estimates, and any suggested methods for minimizing
respondent burden, including through the use of automated collection
techniques to the Director, Collection Strategies Division, U.S.
Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW,
Washington, D.C. 20460. Include the OMB control number in any
correspondence. **Do not send the completed form to this address.**

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> For more information, see instructions.
>
> This submission is: New (to open a new general account)
>
> Revised (to revise information on an existing general account)
>
> This account is authorized to hold allowances in these programs:
>
> Acid Rain/CAIR SO~2~ Trading
>
> CAIR NO~X~ Ozone Season Trading
>
> CAIR NO~X~ Trading
>
> CAMR Hg Budget Trading

Number range CHAPTERIf you are opening a new allowance account, complete
all steps in this form. If this is a revised submission, enter your
account \# and account name and complete Step 4 to authorize the change
of information. Only the authorized account representative or alternate
authorized account representative can authorize the change.

+---------------+------------------------------------+---+--------------+
|               | Account \#                         |   |              |
+---------------+------------------------------------+---+--------------+
|               | Account Name                       |   |              |
+---------------+------------------------------------+---+--------------+
|               |                                    |   |              |
+---------------+------------------------------------+---+--------------+
| **STEP 1**    | Name                               | T |              |
|               |                                    | i |              |
| **Enter       |                                    | t |              |
| requested     |                                    | l |              |
| information   |                                    | e |              |
| for the       |                                    |   |              |
| authorized    |                                    |   |              |
| account       |                                    |   |              |
| repr          |                                    |   |              |
| esentative.** |                                    |   |              |
+---------------+------------------------------------+---+--------------+
|               | Company Name                       |   |              |
+---------------+------------------------------------+---+--------------+
|               | Address                            |   |              |
+---------------+------------------------------------+---+--------------+
|               | Phone Number                       | F |              |
|               |                                    | a |              |
|               |                                    | x |              |
|               |                                    | N |              |
|               |                                    | u |              |
|               |                                    | m |              |
|               |                                    | b |              |
|               |                                    | e |              |
|               |                                    | r |              |
+---------------+------------------------------------+---+--------------+
|               | E-mail Address                     |   |              |
+---------------+------------------------------------+---+--------------+
|               |                                    |   |              |
+---------------+------------------------------------+---+--------------+
| **STEP 2**    | Name                               | T |              |
|               |                                    | i |              |
| **Enter       |                                    | t |              |
| requested     |                                    | l |              |
| information   |                                    | e |              |
| for the       |                                    |   |              |
| alternate     |                                    |   |              |
| authorized    |                                    |   |              |
| account       |                                    |   |              |
| r             |                                    |   |              |
| epresentative |                                    |   |              |
| (required     |                                    |   |              |
| only if you   |                                    |   |              |
| want the      |                                    |   |              |
| general       |                                    |   |              |
| account to    |                                    |   |              |
| have an       |                                    |   |              |
| alternate     |                                    |   |              |
| authorized    |                                    |   |              |
| account       |                                    |   |              |
| repre         |                                    |   |              |
| sentative).** |                                    |   |              |
+---------------+------------------------------------+---+--------------+
|               | Company Name                       |   |              |
+---------------+------------------------------------+---+--------------+
|               | Address                            |   |              |
+---------------+------------------------------------+---+--------------+
|               | Phone Number                       | F |              |
|               |                                    | a |              |
|               |                                    | x |              |
|               |                                    | N |              |
|               |                                    | u |              |
|               |                                    | m |              |
|               |                                    | b |              |
|               |                                    | e |              |
|               |                                    | r |              |
+---------------+------------------------------------+---+--------------+
|               | E-mail Address                     |   |              |
+---------------+------------------------------------+---+--------------+
|               |                                    |   |              |
+---------------+------------------------------------+---+--------------+
| **STEP 3**    | Name                               |   |              |
|               |                                    |   |              |
| **Enter the   |                                    |   |              |
| names of all  |                                    |   |              |
| parties       |                                    |   |              |
| (persons or   |                                    |   |              |
| companies)    |                                    |   |              |
| subject to    |                                    |   |              |
| the binding   |                                    |   |              |
| agreement     |                                    |   |              |
| authorizing   |                                    |   |              |
| your          |                                    |   |              |
| r             |                                    |   |              |
| epresentation |                                    |   |              |
| of the        |                                    |   |              |
| account.**    |                                    |   |              |
+---------------+------------------------------------+---+--------------+
|               | Name                               |   |              |
+---------------+------------------------------------+---+--------------+
|               | Name                               |   |              |
+---------------+------------------------------------+---+--------------+
|               | Name                               |   |              |
+---------------+------------------------------------+---+--------------+
|               |                                    |   |              |
+---------------+------------------------------------+---+--------------+
| **STEP 4**    | [Acid Rain Program]{.underline}    |   |              |
|               |                                    |   |              |
| **Read the    | I certify that I was selected      |   |              |
| c             | under the terms of an agreement    |   |              |
| ertifications | that is binding on all persons who |   |              |
| and sign and  | have an ownership interest with    |   |              |
| date.**       | respect to allowances held in the  |   |              |
|               | Allowance Tracking System account. |   |              |
|               | I certify that I have all          |   |              |
|               | necessary authority to carry out   |   |              |
|               | my duties and responsibilities on  |   |              |
|               | behalf of the persons with an      |   |              |
|               | ownership interest and that they   |   |              |
|               | shall be fully bound by my         |   |              |
|               | actions, inactions, or submissions |   |              |
|               | under 40 CFR Part 73. I am         |   |              |
|               | authorized to make this submission |   |              |
|               | on behalf of the persons with an   |   |              |
|               | ownership interest for whom this   |   |              |
|               | submission is made.                |   |              |
|               |                                    |   |              |
|               | I certify under penalty of law     |   |              |
|               | that I have personally examined,   |   |              |
|               | and am familiar with, the          |   |              |
|               | statements and information         |   |              |
|               | submitted in this document and all |   |              |
|               | its attachments. Based on my       |   |              |
|               | inquiry of those individuals with  |   |              |
|               | primary responsibility for         |   |              |
|               | obtaining the information, I       |   |              |
|               | certify that the statements and    |   |              |
|               | information are to the best of my  |   |              |
|               | knowledge and belief true,         |   |              |
|               | accurate, and complete. I am aware |   |              |
|               | that there are significant         |   |              |
|               | penalties for submitting false     |   |              |
|               | statements and information or      |   |              |
|               | omitting material information,     |   |              |
|               | including the possibility of fine  |   |              |
|               | or imprisonment for violations.    |   |              |
|               |                                    |   |              |
|               | [Clean Air Interstate Rule (CAIR)  |   |              |
|               | NO~X~ Annual Trading               |   |              |
|               | Program]{.underline}               |   |              |
|               |                                    |   |              |
|               | I certify that I was selected as   |   |              |
|               | the CAIR authorized account        |   |              |
|               | representative or the alternate    |   |              |
|               | CAIR authorized account            |   |              |
|               | representative, as applicable, by  |   |              |
|               | an agreement that is binding on    |   |              |
|               | all persons who have an ownership  |   |              |
|               | interest with respect to CAIR      |   |              |
|               | NO~X~ allowances held in the       |   |              |
|               | general account. I certify that I  |   |              |
|               | have all the necessary authority   |   |              |
|               | to carry out my duties and         |   |              |
|               | responsibilities under the CAIR    |   |              |
|               | NO~X~ Annual Trading Program on    |   |              |
|               | behalf of such persons and that    |   |              |
|               | each such person shall be fully    |   |              |
|               | bound by my representations,       |   |              |
|               | actions, inactions, or submissions |   |              |
|               | and by any order or decision       |   |              |
|               | issued to me by the Administrator  |   |              |
|               | or a court regarding the general   |   |              |
|               | account.                           |   |              |
|               |                                    |   |              |
|               | I am authorized to make this       |   |              |
|               | submission on behalf of the        |   |              |
|               | persons having an ownership        |   |              |
|               | interest with respect to the CAIR  |   |              |
|               | NO~X~ allowances held in the       |   |              |
|               | general account. I certify under   |   |              |
|               | penalty of law that I have         |   |              |
|               | personally examined, and am        |   |              |
|               | familiar with, the statements and  |   |              |
|               | information submitted in this      |   |              |
|               | document and all its attachments.  |   |              |
|               | Based on my inquiry of those       |   |              |
|               | individuals with primary           |   |              |
|               | responsibility for obtaining the   |   |              |
|               | information, I certify that the    |   |              |
|               | statements and information are to  |   |              |
|               | the best of my knowledge and       |   |              |
|               | belief true, accurate, and         |   |              |
|               | complete. I am aware that there    |   |              |
|               | are significant penalties for      |   |              |
|               | submitting false statements and    |   |              |
|               | information or omitting required   |   |              |
|               | statements and information,        |   |              |
|               | including the possibility of fine  |   |              |
|               | or imprisonment.                   |   |              |
|               |                                    |   |              |
|               | [Clean Air Interstate Rule (CAIR)  |   |              |
|               | SO~2~ Trading Program]{.underline} |   |              |
|               |                                    |   |              |
|               | I certify that I was selected as   |   |              |
|               | the CAIR authorized account        |   |              |
|               | representative or the alternate    |   |              |
|               | CAIR authorized account            |   |              |
|               | representative, as applicable, by  |   |              |
|               | an agreement that is binding on    |   |              |
|               | all persons who have an ownership  |   |              |
|               | interest with respect to CAIR      |   |              |
|               | SO~2~ allowances held in the       |   |              |
|               | general account. I certify that I  |   |              |
|               | have all the necessary authority   |   |              |
|               | to carry out my duties and         |   |              |
|               | responsibilities under the CAIR    |   |              |
|               | SO~2~ Trading Program on behalf of |   |              |
|               | such persons and that each such    |   |              |
|               | person shall be fully bound by my  |   |              |
|               | representations, actions,          |   |              |
|               | inactions, or submissions          |   |              |
+---------------+------------------------------------+---+--------------+
|               | and by any order or decision       |   |              |
|               | issued to me by the Administrator  |   |              |
|               | or a court regarding the general   |   |              |
|               | account.                           |   |              |
|               |                                    |   |              |
|               | I am authorized to make this       |   |              |
|               | submission on behalf of the        |   |              |
|               | persons having an ownership        |   |              |
|               | interest with respect to the CAIR  |   |              |
|               | SO~2~ allowances held in the       |   |              |
|               | general account. I certify under   |   |              |
|               | penalty of law that I have         |   |              |
|               | personally examined, and am        |   |              |
|               | familiar with, the statements and  |   |              |
|               | information submitted in this      |   |              |
|               | document and all its attachments.  |   |              |
|               | Based on my inquiry of those       |   |              |
|               | individuals with primary           |   |              |
|               | responsibility for obtaining the   |   |              |
|               | information, I certify that the    |   |              |
|               | statements and information are to  |   |              |
|               | the best of my knowledge and       |   |              |
|               | belief true, accurate, and         |   |              |
|               | complete. I am aware that there    |   |              |
|               | are significant penalties for      |   |              |
|               | submitting false statements and    |   |              |
|               | information or omitting required   |   |              |
|               | statements and information,        |   |              |
|               | including the possibility of fine  |   |              |
|               | or imprisonment.                   |   |              |
|               |                                    |   |              |
|               | [Clean Air Interstate Rule (CAIR)  |   |              |
|               | NO~X~ Ozone Season Trading         |   |              |
|               | Program]{.underline}               |   |              |
|               |                                    |   |              |
|               | I certify that I was selected as   |   |              |
|               | the CAIR authorized account        |   |              |
|               | representative or the alternate    |   |              |
|               | CAIR authorized account            |   |              |
|               | representative, as applicable, by  |   |              |
|               | an agreement that is binding on    |   |              |
|               | all persons who have an ownership  |   |              |
|               | interest with respect to CAIR      |   |              |
|               | NO~X~ Ozone Season allowances held |   |              |
|               | in the general account. I certify  |   |              |
|               | that I have all the necessary      |   |              |
|               | authority to carry out my duties   |   |              |
|               | and responsibilities under the     |   |              |
|               | CAIR NO~X~ Ozone Season Trading    |   |              |
|               | Program on behalf of such persons  |   |              |
|               | and that each such person shall be |   |              |
|               | fully bound by my representations, |   |              |
|               | actions, inactions, or submissions |   |              |
|               | and by any order or decision       |   |              |
|               | issued to me by the Administrator  |   |              |
|               | or a court regarding the general   |   |              |
|               | account.                           |   |              |
|               |                                    |   |              |
|               | I am authorized to make this       |   |              |
|               | submission on behalf of the        |   |              |
|               | persons having an ownership        |   |              |
|               | interest with respect to the CAIR  |   |              |
|               | NO~X~ Ozone Season allowances held |   |              |
|               | in the general account. I certify  |   |              |
|               | under penalty of law that I have   |   |              |
|               | personally examined, and am        |   |              |
|               | familiar with, the statements and  |   |              |
|               | information submitted in this      |   |              |
|               | document and all its attachments.  |   |              |
|               | Based on my inquiry of those       |   |              |
|               | individuals with primary           |   |              |
|               | responsibility for obtaining the   |   |              |
|               | information, I certify that the    |   |              |
|               | statements and information are to  |   |              |
|               | the best of my knowledge and       |   |              |
|               | belief true, accurate, and         |   |              |
|               | complete. I am aware that there    |   |              |
|               | are significant penalties for      |   |              |
|               | submitting false statements and    |   |              |
|               | information or omitting required   |   |              |
|               | statements and information,        |   |              |
|               | including the possibility of fine  |   |              |
|               | or imprisonment.                   |   |              |
|               |                                    |   |              |
|               | [Clean Air Mercury Rule (CAMR)     |   |              |
|               | Trading Program]{.underline}       |   |              |
|               |                                    |   |              |
|               | I certify that I was selected as   |   |              |
|               | the CAMR authorized account        |   |              |
|               | representative or the alternate Hg |   |              |
|               | authorized account representative, |   |              |
|               | as applicable, by an agreement     |   |              |
|               | that is binding on all persons who |   |              |
|               | have an ownership interest with    |   |              |
|               | respect to Hg allowances held in   |   |              |
|               | the general account. I certify     |   |              |
|               | that I have all the necessary      |   |              |
|               | authority to carry out my duties   |   |              |
|               | and responsibilities under the Hg  |   |              |
|               | Budget Trading Program on behalf   |   |              |
|               | of such persons and that each such |   |              |
|               | person shall be fully bound by my  |   |              |
|               | representations, actions,          |   |              |
|               | inactions, or submissions and by   |   |              |
|               | any order or decision issued to me |   |              |
|               | by the Administrator or a court    |   |              |
|               | regarding the general account.     |   |              |
|               |                                    |   |              |
|               | I am authorized to make this       |   |              |
|               | submission on behalf of the        |   |              |
|               | persons having an ownership        |   |              |
|               | interest with respect to the Hg    |   |              |
|               | allowances held in the general     |   |              |
|               | account. I certify under penalty   |   |              |
|               | of law that I have personally      |   |              |
|               | examined, and am familiar with,    |   |              |
|               | the statements and information     |   |              |
|               | submitted in this document and all |   |              |
|               | its attachments. Based on my       |   |              |
|               | inquiry of those individuals with  |   |              |
|               | primary responsibility for         |   |              |
|               | obtaining the information, I       |   |              |
|               | certify that the statements and    |   |              |
|               | information are to the best of my  |   |              |
|               | knowledge and belief true,         |   |              |
|               | accurate, and complete. I am aware |   |              |
|               | that there are significant         |   |              |
|               | penalties for submitting false     |   |              |
|               | statements and information or      |   |              |
|               | omitting required statements and   |   |              |
|               | information, including the         |   |              |
|               | possibility of fine or             |   |              |
|               | imprisonment.                      |   |              |
+---------------+------------------------------------+---+--------------+
|               |                                    |   |              |
+---------------+------------------------------------+---+--------------+
|               | Signature (Authorized Account      |   | Date         |
|               | Representative)                    |   |              |
+---------------+------------------------------------+---+--------------+
|               | Signature (Alternate Authorized    |   | Date         |
|               | Account Representative, if any)    |   |              |
+---------------+------------------------------------+---+--------------+

+---------------+------------------------------------+---+--------------+
| **STEP 5      | Is the authorized account          |   |              |
| (Optional)**  | representative employed by an      |   |              |
|               | allowance brokerage firm?          |   |              |
| **Respond to  |                                    |   |              |
| the questions | No                                 |   |              |
| by marking    |                                    |   |              |
| all           | Yes (if yes, please mark all boxes |   |              |
| appropriate   | that apply)                        |   |              |
| boxes. (EPA   |                                    |   |              |
| will use this | This account will be used to       |   |              |
| information   | transfer allowances between        |   |              |
| for program   | clients                            |   |              |
| evaluation    |                                    |   |              |
| purposes      | This account will be used to hold  |   |              |
| only.)**      | allowances for investment purposes |   |              |
|               |                                    |   |              |
|               | This account will be used for      |   |              |
|               | other purposes                     |   |              |
+---------------+------------------------------------+---+--------------+
|               |                                    |   |              |
+---------------+------------------------------------+---+--------------+
|               | What types of business are         |   |              |
|               | represented by the owner(s) of     |   |              |
|               | allowances in this account (mark   |   |              |
|               | all boxes                          |   |              |
|               |                                    |   |              |
|               | that apply)?                       |   |              |
|               |                                    |   |              |
|               | Utility                            |   |              |
|               |                                    |   |              |
|               | Non-Utility Generators of          |   |              |
|               | Electricity                        |   |              |
|               |                                    |   |              |
|               | Industrial Boiler                  |   |              |
|               |                                    |   |              |
|               | Fuel Supplier                      |   |              |
+---------------+------------------------------------+---+--------------+
|               | \_\_\_\_\_\_\_ Coal \_\_\_\_\_\_\_ |   |              |
|               | Oil                                |   |              |
+---------------+------------------------------------+---+--------------+
|               | \_\_\_\_\_\_\_ Gas \_\_\_\_\_\_\_  |   |              |
|               | Other                              |   |              |
+---------------+------------------------------------+---+--------------+
|               | Pollution Control Equipment        |   |              |
|               | Manufacturer or distributor        |   |              |
|               |                                    |   |              |
|               | Public Interest Group              |   |              |
+---------------+------------------------------------+---+--------------+
|               | \_\_\_\_\_\_\_ Consumer            |   |              |
|               | \_\_\_\_\_\_\_ Other               |   |              |
+---------------+------------------------------------+---+--------------+
|               | \_\_\_\_\_\_\_ Environmental       |   |              |
+---------------+------------------------------------+---+--------------+
|               |                                    |   |              |
+---------------+------------------------------------+---+--------------+
|               | Other Number range                 |   |              |
|               | CHAPT                              |   |              |
|               | ER───────────────────────────────▸ |   |              |
+---------------+------------------------------------+---+--------------+
|               |                                    |   |              |
+---------------+------------------------------------+---+--------------+
| **Submission\ | **Mail to the following address:** |   |              |
| Information** |                                    |   |              |
+---------------+------------------------------------+---+--------------+
|               | By regular/certified mail: Or      |   |              |
|               | overnight mail:                    |   |              |
|               |                                    |   |              |
|               | U.S. Environmental Protection      |   |              |
|               | Agency U.S. Environmental          |   |              |
|               | Protection Agency                  |   |              |
|               |                                    |   |              |
|               | Clean Air Markets Division (6204J) |   |              |
|               | Clean Air Markets Division (6204J) |   |              |
|               |                                    |   |              |
|               | Attn: Allowance Tracking System    |   |              |
|               | Attn: Allowance Tracking System    |   |              |
|               |                                    |   |              |
|               | 1200 Pennsylvania Avenue, NW 1310  |   |              |
|               | L Street, NW                       |   |              |
|               |                                    |   |              |
|               | Washington, DC 20460 Second Floor, |   |              |
|               | Office 202B                        |   |              |
|               |                                    |   |              |
|               | Washington, DC 20005               |   |              |
|               |                                    |   |              |
|               | \(202\) 343-9168                   |   |              |
+---------------+------------------------------------+---+--------------+