2016 Exemption certificate form - Clean Energy · PDF fileV2.0 12/02/2016 2016 Application for exemption certificate 1 of 31 ... Declaration Part I: Statutory ... using a separate

V2.0 12/02/2016 2016 Application for exemption certificate 1 of 31

2016 Application for an exemption certificate under the Renewable Energy (Electricity) Act 2000

Purpose of this form

Division 1A, Part 4 of the Renewable Energy (Electricity) Act 2000 (the Act) provides exemption from Large-scale Renewable Energy Target (LRET) and the Small-scale Renewable Energy Scheme (SRES) liability for electricity supplied to emissions-intensive trade-exposed (EITE) activities.

Subject to agreement from the prescribed person an exemption certificate may be traded to the Renewable Energy Target (RET) liable entity, and provides the RET liable entity with exemption from liability for a certain amount of megawatt-hours of electricity in the given compliance year.

Eligibility

A prescribed person may apply under subsection 46A(1) of the Act to the Clean Energy Regulator for an exemption certificate in relation to a RET liable entity for electricity supplied to an EITE activity carried on at a site during a calendar year. Eligible EITE activities are defined in Schedule 6 to the Renewable Energy (Electricity) Regulations 2001 (the Regulations).

Submitting this form

The form must be received by the Clean Energy Regulator no later than close of business on 30 March 2016.

By post

Post your completed application with any accompanying documentation to:

Clean Energy Regulator Industrial and Transport section GPO Box 621 Canberra ACT 2601

A copy of the signed form should be kept for your records.

By fax

You can submit your completed application via facsimile to 02 6159 3355. Please ensure that the original hard copy is also sent in the post.

FORM

CER-RET-020

V2.0 12/02/2016

CER-RET-020


Instructions for completing this form

Please read each part of this application carefully, fully answer all the questions, sign where indicated, and attach the required documentation.

You must complete and submit:

Part A: Prescribed person

Part B: Applicant details

Part C: RET liable entity

Part D: Emissions-intensive trade-exposed activity

Part E: Site details

Part F: Quantity of relevant product

Part G: Exemption calculation

Part H: Declaration

Part I: Statutory declaration

If there is not sufficient space to complete your answer, provide the answer as an attachment.

Please reference and label attachments in a logical manner. Lengthy or large attachments may be provided in electronic format.

You can choose to complete this form by:

printing this application form and filling it in by hand, or

saving this application form and filling in an electronic copy.

Note that if you choose the second option, there may be times when you will need to print certain sections in order to sign them or in order to complete multiple entries for a single set of questions.

Pen colours Please use a black or blue pen to write on the form.

Check boxes Mark boxes like this with a ✔ or ✘. When an instruction asks you to ‘tick’ the box, you can

still use either ✔ or ✘.

Go to Where you see an instruction like this - Go to question 5 - mark the relevant box with a ✔

or ✘and then skip to the question number shown. You do not need to answer the question(s) in between.

Where an instruction has a black double arrow (), go to the next indicated part/section. Where an instruction has a black single arrow (), go to the next question. Where an instruction has a black single arrow pointing down (), fill in the field(s) directly below it.

Mandatory questions

If all fields in a question are mandatory and must be completed, (required) is added to the end of the question label text. If a field in a question is mandatory only IF a condition is met, (required if any) is added to the end of the question label text.

This symbol indicates an instruction on what to do next.

This symbol indicates additional useful guidance to filling in the adjacent field or section.

CER-RET-020


This symbol advises that more than one entry may be required for the section and therefore you may need to photocopy or print the section or fill in a duplicate section.

This symbol advises that additional documentation to support a claim may need to be attached to this application.

Help filling in this form

Guidance for filling in this form is available on the Clean Energy Regulator website1.

If you require assistance or have any questions regarding this application process, please contact the Clean Energy Regulator general enquiries line on 1300 553 542 or email [email protected].

How to manage parts of the application


An application for an exemption certificate must be made by a prescribed person who will receive the exemption certificate (this is generally the entity carrying on the EITE activity). Subdivision A of Division 4 of Part 3A of the Regulations details the categories of prescribed persons. Please provide a description and attach supporting documentation to evidence which prescribed person category you belong to.


This section includes the name and other identifying details of the applicant, executive office, and where applicable, contact persons.


The RET liable entity is the entity which incurs the liability under the Act for the electricity supplied to the site (this is generally the electricity retailer).

If the RET liable entity changes during a year, the prescribed person may apply (under regulation 22L) to have the original exemption certificate amended and another exemption certificate issued in relation to the new RET liable entity, using a separate application form ‘Application for exemption certificate - change of liable entity’, which is available on the Clean Energy Regulator website2. Applications for the 2016 year must be made on or before 31 December 2016.

If there are concurrent multiple RET liable entities for the electricity used in an EITE activity at a site, the prescribed person may apply to have the original exemption certificate amended and another exemption certificate issued in relation to another of the RET liable entities, using a separate application form ‘Application for exemption certificate - multiple liable entities’, which is available on the Clean Energy Regulator website3. Applications for the 2016 year must be made on or before 30 June 2016 (under regulation 22M(b)(i)), or on or before 31 December 2016 (under regulation 22M(b)(ii)).


1 http://www.cleanenergyregulator.gov.au/RET/Forms-and-resources/Forms-and-resources-for-industry



http://www.cleanenergyregulator.gov.au/RET/Forms-and-resources/Forms-and-resources-for-industry

mailto:[email protected]






CER-RET-020


It is the responsibility of the prescribed person to identify whether an EITE activity is carried on at a site. Eligible EITE activities are defined in Schedule 6 of the Regulations.

Please indicate at question 26 which EITE activity this application relates to. If you wish to apply for exemption for other EITE activities carried on at the site then you will need to lodge a separate application in respect of each EITE activity.


Provide details of the site at which the EITE activity is carried on, including electricity generation and consumption details.


At question 41, please indicate whether the site is part of an activity group as defined in Regulation 22A(9). If the site is part of an activity group, you must complete and attach ‘Appendix A: EITE activity group’. If the site is not part of an activity group (or is part of an activity group where at all the other sites in the activity group the EITE activity is only carried out in an auxiliary manner), then the relevant product is referrable to a single site. If the site is part of an activity group (excluding an activity group where at all the other sites in the activity group the EITE activity is only carried out in an auxiliary manner) then the relevant product relates to multiple sites in the activity group.

If the site meets the criteria for a new entrant under subregulation 22ZD(3), please complete and attach ‘Appendix B: New entrant production’ (available from the Clean Energy Regulator website4).

If the site meets the criteria for a significant expansion under subregulation 22ZD(4), please complete and attach ‘Appendix C: Expected additional production’ (available from the Clean Energy Regulator website5).

If more than one type of relevant product is produced from the EITE activity at the site, please complete and attach ‘Appendix D: Quantity of relevant product’ (available from the Clean Energy Regulator website6) to calculate the ASP amount in relation to each type of relevant product. For example, if the EITE activity ‘production of magnesia’ at a site results in the relevant products of ‘caustic calcined magnesia’ and ‘deadburned magnesia’, then complete Part F in relation to the quantity of ‘caustic calcined magnesia’, and complete and attach Appendix D in relation to the quantity of ‘deadburned magnesia’.


Evaluate the amount of exemption that you expect should be set out in the exemption certificate for 2016.

If you have reported quantities of more than one type of relevant product, use a separate row to perform the exemption calculation for each different type of relevant product.

Refer to Appendix E for a summary of the electricity baselines for each relevant product from Schedule 6 to the Regulations.

State assumptions made about any values, or amounts, relevant to the exemption calculation which are not known at the time of making the application.

4 http://www.cleanenergyregulator.gov.au/RET/Scheme-participants-and-industry/Industry-assistance/Applying-for-

exemption-certificates 5 http://www.cleanenergyregulator.gov.au/RET/Scheme-participants-and-industry/Industry-assistance/Applying-for-

exemption-certificates 6 http://www.cleanenergyregulator.gov.au/RET/Scheme-participants-and-industry/Industry-assistance/Applying-for-

exemption-certificates




http://www.cleanenergyregulator.gov.au/RET/Scheme-participants-and-industry/Industry-assistance/Applying-for-exemption-certificates






CER-RET-020


If the amount of exemption applied for exceeds 15,000 MWh for 2016 then you will need to attach an audit report that complies with regulation 22UB. Guidelines relating to the audit report are available from the Clean Energy Regulator website.

Part H: Declaration

The part signed by the signatory indicating that the information in this form is true and correct and the key obligations of the signatory and the Clean Energy Regulator.

Part I: Statutory Declaration

A separate Statutory Declaration that must be made by a director of the applicant or the applicant’s chief executive officer, the applicant’s chief financial officer or company secretary.

CER-RET-020



Please indicate the category of prescribed persons under which you are making this application. You must attach supporting documentation as required.

1. Prescribed person type (required)

Tick one of the boxes below to state the applicable prescribed person category, complete the relevant section.

Tick If you are a: Please complete only:

person with a contract for electricity supply to the site ( as defined by regulation 22G)

Section A1

liable entity with operational control of the facility, supplying electricity to the site (as defined by regulation 22H)

Section A2

liable entity that will have operational control of the facility, to supply electricity for a future EITE activity at the site(as defined by regulation 22I)

Section A3

person with a new contract for electricity supply to the site ( as defined by regulation 22J)

Section A4

person nominated as the ‘controlling’ person of the facility at the time of application (as defined by regulation 22K)

Section A5

Give a brief explanation as to how you fit into your prescribed person category stated above.

Explanation

A1. Person with contract for supply of electricity to site

Only complete this section if the applicant is a person with a contract for a supply of electricity to the site for all or part of the preceding year (as defined in regulation 22G).

If you complete and submit this section, you do not need to complete sections A2, A3, A4 or A5.

2. During the 2015 year (or part thereof), were you a party to a contract with a RET liable entity for the supply of electricity consumed at the site? (required)

Yes

No

3. Are you currently a party to a contract for the supply of electricity consumed at the site? (required)

Yes

No

Attach a copy of the schedule to the current contract (unless this has already been submitted to the Clean Energy Regulator with a previous exemption certificate application).

Attached

The schedule to the current contract has previously been supplied

You have completed this section. Go directly to Part B.

CER-RET-020


A2. RET liable entity with operation control

Only complete this section if the applicant is a RET liable entity with operational control of the facility for the preceding six months, supplying electricity to the site (as defined in regulation 22H).


4. During the prior six months, were you the RET liable entity for the majority of the electricity consumed at the site that gives rise to a relevant acquisition? (required)

Yes

No

5. During the prior six months, were you the RET liable entity for over 30% of the electricity consumed at the site? (required)

Yes

No

6. Do you currently have operational control of the principal facility that the EITE activity is carried on at the site? (required)

Yes

No


A3. RET liable entity for future EITE activity

Only complete this section if the applicant is a RET liable entity who will have operational control of the facility, to supply electricity for a future EITE activity at the site (as defined in regulation 22I).


7. Is the EITE activity currently carried on at the site? (required)

Yes

No

8. Is the EITE activity to be carried out at the site during 2016? (required)

Yes

No

9. When the EITE activity is first carried on at the site, will you have operational control of the principal facility that is carried on at the site? (required)

Yes

No

CER-RET-020


10. When the EITE activity is first carried on at the site, will you be the RET liable entity for more than 30 per cent of the electricity consumed at the site during 2016? (required)

Yes

No


A4. Person with a new contract for supply of electricity

Only complete this section if the applicant is a person with a new contract for a supply of electricity to the site (as defined in regulation 22J).


11. Is there currently a prescribed person of a kind mentioned in regulation 22G, 22H or 22I? (required)

Yes

No

12. Are you eligible to be a prescribed person under regulation 22G, 22H or 22I? (required)

Yes

No

13. Are you a party to a contract with a RET liable entity for a supply of electricity to be consumed at the site in 2016? (required)

Yes

No

Attach a copy of the schedule to the contract.

Attached


A5. Nominated person

Only complete this section if the applicant is nominated as the ‘controlling’ person of the facility at the time of application (as defined in regulation 22K).


14. Was there written notice given to the Clean Energy Regulator stating that you may apply for an exemption certificate for the EITE activity and the site with respect to the 2016 year? (required)

Yes

No

Attach a copy of the notice to this application.

Attached

CER-RET-020


15. To determine whether you are a controlling person in relation to the principal facility carried on at the site:

a) Do you have operational control of the facility? (required)

Yes

No

b) Are you a controlling corporation with a member of your group having operational control of the facility? (required)

Yes

No

c) Do you have financial control over the facility? (required)

Yes

No

CER-RET-020



Applicant details

Please provide details relating to the applicant.

16. Applicant name (required)

This is the name that appears on the Australian Business Register.

Name

17. Trading name (required if any)

Provide the trading name, if any.

Name

18. Postal address (required)

The Clean Energy Regulator will use this address for all correspondence related to the assessment of this application.

Address line 1

Address line 2

Address line 3

Suburb/city

State/territory

Postcode

Country

19. Identifying details (required)

You must provide one of the following for the applicant in order of precedence: Australian Business Number (ABN), Australian Company Number (ACN), Australian Registered Body Number (ARBN) or trading name and street address.

ABN

If the applicant does not have an ABN, please provide the applicant’s ACN.

ACN

If the applicant does not have an ABN or an ACN, please provide the applicant’s ARBN.

ARBN

If the applicant does not have an ABN, ACN or an ARBN please provide the applicant's trading name and street address.

Is the trading name and the street address the same as those provided at questions 17 and 18?

Yes Go to question 20

No Provide details below

CER-RET-020


Trading name

Address line 1

Address line 2

Suburb/city

State/territory

Postcode

Country

Primary contact person

Nominate a primary contact person with whom the Clean Energy Regulator will deal on matters relating to the application.

20. Primary contact person’s details (required)

Provide the person’s full name.

Title (e.g. Mr, Mrs,

Dr)

Given name(s)

Last name

Provide the person’s position.

Position

Provide the person’s contact details.

Phone number

Email

CER-RET-020


Secondary contact person

The Clean Energy Regulator may contact this person if the primary contact is not contactable.

21. Secondary contact person’s details (required)

Provide the person’s full name.


Dr)

Given name(s)

Last name

Provide the person’s position.

Position

Provide the person’s contact details.

Phone number

Email

Executive officer

The Clean Energy Regulator may contact this person if required.

22. Executive officer details (required)

Provide the executive officer’s full name.


Dr)

Given name(s)

Last name

Provide the executive officer’s position.

Position

Provide the executive officer’s contact details.

Phone number

Email

CER-RET-020



The Clean Energy Regulator may contact the RET liable entity about this application; we will seek your permission if we require clarification about the information provided in this application.

Once issued with an exemption certificate in relation to the RET liable entity stated at question 23 below, if the RET liable entity changes during the year you may apply to have the original exemption certificate amended and another exemption certificate issued in relation to the new RET liable entity, using a separate application form ‘Application for exemption certificate - change of RET liable entity’, on or before 31 December 2016.

Liable entity details

Please provide details of the RET liable entity for electricity used at the site, whom the exemption certificate will relate to.

23. Liable entity details (required)

Provide the name of the RET liable entity.

This is the name that appears on the Australian Business Register.

Company name

Provide the trading name if any.

Trading name

Which name is used in the Renewable Energy Certificate (REC) Registry?

Company name

Trading name

Provide the ABN for the RET liable entity.

ABN

Other RET liable entity details

Please provide details of any other RET liable entities for electricity used at the site.

24. At 1 January 2016, apart from the RET liable entity stated at question 23 were there one or more other RET liable entities for electricity used at the site? (required)

Yes Provide details below

No Go to Part D

Details on other RET liable

entities

25. Do you intend to apply to be a prescribed person under regulation 22M(b)(i) or 22M(b)(ii) for a second RET liable entity for electricity used in the EITE activity at the site in 2016? (required if any)

Yes Once you have been issued your exemption certificate, please complete an ‘Application for exemption certificate – multiple liable entities’

No

CER-RET-020



In this section, you will identify the emissions-intensive trade-exposed (EITE) activity carried out at the site relating to this application.

26. EITE activity details (required)

Identify the EITE activity to which this application relates.

A list of all eligible EITE activities is included in Schedule 6 to the Regulations and summarised in Appendix E to this form.

Name of EITE activity

27. EITE activity status (required)

Is the EITE activity currently carried on at the site?


No Go to question 28

28. Commencement date (required if any)

What date is the EITE activity expected to commence at the site?

Day (dd) Month (mm) Year (yyyy)

Date

29. Licenses, permissions and approvals (required if any)

State what licenses, permissions or approvals are necessary to carry on the EITE activity at the site and whether they have already been obtained.

Attach copies of any approvals necessary to carry on the EITE activity.

Licenses, permissions and

approval

30. How will the EITE activity be carried on at the site (required)

Describe how the EITE activity will be carried on in the context of total production at the site in 2016, and state how requirements relating to the relevant activity definition under Schedule 6 to the Regulations are met.

If insufficient space please provide additional information as an attachment.

How the EITE activity is

carried on at the site

CER-RET-020



Provide details of the site at which the EITE activity is carried on.

31. Site name (required)

As commonly referred to for business purposes.

Site name

32. Provide details of any generation capacity at the site (including technology and MW rating of each generator) and whether the generation gives rise to a relevant acquisition (required if any)

Details

33. Is any electricity used at the site that is not a relevant acquisition because of subsection 31(2) of the Act? (required)

Yes Provide details below


Explanation

34. Complete the following information for the 2014–15 financial year (required) a) What was the total amount of electricity consumed at the site?

(EC) MWh

b) What was the amount of electricity generated, and consumed, at the site for which there is no relevant acquisition?

Electricity generation from a generator with a nameplate rating of less than 1MW may be disregarded.

(A) MWh

c) What was the amount of electricity delivered to the site for which no relevant acquisition occurs between the point of generation and the point of use?

(B) MWh

d) Subtotal (A) + (B)

(EG) MWh

e) What is the proportion of electricity used at the site that constitutes a relevant acquisition?

Please calculate quantity (G) using the formula:

(G) %

CER-RET-020


35. Indicate any planned changes to the site or EITE activity in the next two years that will have a material effect on future levels of electricity consumption (required if any)

Details

36. Site maps (required)

Provide map/s of the site, such as topographical or site map/s and electrical line diagram/s. Tick the box to confirm maps are attached. The maps must show:

Where the EITE is carried out at the site (You must supply an updated map/s if ANY changes have occurred to the site since previous map/s supplied)

sources of electricity generation (including nameplate rating in MW of each generator) that are part of the site

connections to an electricity grid with a capacity that is 100MW or more, and

any other points at which electricity is delivered to the site.

Alternatively, if maps were provided to the Clean Energy Regulator with a previous exemption certificate application and no changes have occurred to the site as reflected on those maps, you do not need to resupply those maps.

Maps attached

All relevant maps were provided to the Clean Energy Regulator with a previous exemption certificate application and no changes have occurred to the site reflected on those maps

37. Physical address of the site (required)

Address

Suburb/city

State/territory

Postcode

38. Geographic coordinates (required)

Google Maps

Latitude Longitude

Facility geocode as a decimal. Use 3 decimal places e.g. latitude is 28.495 and longitude is 146.256

39. Is the site connected to the National Electricity Market (NEM) (required)

Yes

No Provide details below

Electricity network

40. Provide the National Metering Identifier/s or other unique metering identifier/s for the site (required)

Metering identifier/s

http://maps.google.com.au/

CER-RET-020



In Part F, provide details of the quantity of relevant product for 2014-15 in relation to the EITE activity carried on at the site. Provide additional information as attachments if required.

For each additional relevant product, please complete a copy of Appendix D then attach it to the application.

41. Is the site part of an activity group? (required)

If no, relevant product is referrable to single site.



42. Is the EITE activity only carried on in an ancillary way at all other sites in the activity group? (required)

If yes, relevant product is referrable to single site. If no, relevant product relates to multiple sites in activity group.


No Complete Appendix A: EITE activity group and continue to question 43

43. Does the site meet the criteria for a new entrant under regulation 22ZD(3)? (required)

Yes Complete Appendix B: New entrant and continue to question 44


44. Does the site meet the criteria for a significant expansion under regulation 22ZD(4)? (required)

Yes Complete Appendix C: Expected additional production and continue to question 45


45. Detail the annual capacity of the EITE activity at the site in relation to the quantity of each relevant product, and indicate any planned changes to the EITE activity (in the next two years approximately), that will have a material effect on future quantities of relevant product (required)

Explanation

46. What type of relevant product are you reporting the quantity of? (required)

Relevant product

47. For the 2014–15 financial year, what was the quantity of relevant product (SP2014-15) referrable to the site? (required)

If relevant product relates to multiple sites in an activity group, calculate quantity (SP2014-15) using the formula:

SP2014-15

What units were used?

tonnes

kilolitres

CER-RET-020


48. Explain the basis on which the quantity SP2014-15 of relevant product was determined (required)

You must state your product specification range and describe how it was determined to comply with material properties or specifications specified in the relevant activity definition under Schedule 6 to the Regulations.

How the quantity of

relevant product was determined

49. Describe the method of measuring the quantity SP2014-15 of relevant product? (required)

The method of measuring the

quantity of relevant product

50. Is quantity SP2014-15 of relevant product referrable to the site in accordance with the conditions of regulation 22B? (required)

Product must relate to the site that is the subject of the application unless it was part of an activity group and calculated accordingly.

Yes

No

51. Complete the following information in relation to quantity SP2014-15 (required if any)

The quantity of relevant product being the subject to this application must be of saleable quality as defined in Regulation 22C.

Only answer this question (parts a, b, c and d) if the relevant product is required to be saleable quality under Division 3 of the relevant EITE activity definition in Schedule 6 of the Regulations.

a) Was it produced to a level that would ordinarily be considered by participants in the relevant market to have a commercial value as the output of a process carried on as part of the EITE activity?

Yes

No Please state reason for not adjusting SP2014-15 accordingly:

b) Does it include any quantity of sub-standard product that was discarded?

Yes Please state reason for not adjusting SP2014-15 accordingly:

No

c) Does it include any quantity of product that has already been of saleable quality?


No

d) Does it include any quantity of product that was scrapped or lost before being packaged as a product of saleable quality?


No

CER-RET-020


52. What was the quantity of relevant product referrable to the site for the 2013–14 financial year (assessed in the 2015 PEC application)? (required if any)

SP2013-14


tonnes

kilolitres

53. Calculate the quantity ASP for 2016 based on the method of regulation 22ZB (required)

Note that ST2015-16 = (SP2014-15 - SP2013-14 - EASP2014-15) is the adjustment for the previous financial year’s production. If no exemption certificate was issued for the EITE activity at the site in 2015, then ST2015-16 = 0.

Provide details of your calculation.

SP2014-15 EASP2015-16

from appendix B or C SP2014-15 SP2013-14 EASP2014-15 ASP

+ + ( - - ) =


tonnes

kilolitres

Definitions

SP2014-15 is the quantity of relevant product produced in the 2014–15 financial year from question 47

EASP2015-16 is the quantity of new or expected additional production for the 2015–16 financial year from Appendix B or Appendix C (if applicable)

SP2013-14 is the quantity of relevant product produced in the 2013–14 financial year from question 52 (if applicable)

EASP2014-15 is the quantity of new or expected additional production for the 2014–15 financial year as assessed in the 2015 exemption certificate application (if applicable)

ASP is the resultant quantity of relevant product

CER-RET-020



In Part G, you will estimate the exemption for 2016.

54. State the amount exemption you expect for 2016 in relation to the EITE activity and site, based on the method of regulation 22ZA (required)

Provide details of your calculation.

For each relevant product, exemption is calculated by applying the exemption assistance rate (k) to the amount of liable electricity used in the EITE activity at the site during the year (EP x ASP x G).

If applicable, use a separate row to perform the calculation for each different type of relevant product.

EP ASP K G (%) (MWh)

Relevant product 1 x x 1 x =





Sum the MWh amounts to calculate the total estimated exemption.

Total estimated exemption (MWh)

Definitions

EP is the electricity baseline from Schedule 6 of the Regulations (summarised in Appendix E)

ASP is the quantity of relevant product from question 53 (and Appendix B if applicable)

G is the ratio of liable/total electricity from question 34(e)

k is the exemption assistance rate of 100%, calculated using the formula of regulation 22ZA(1):

55. State any assumptions made about values or amounts not known at the time of the application in order to calculate the amount of exemption at question 54 (required if any)

Assumptions

56. Does the estimated amount of exemption applied for exceed 15,000 MWh for 2016? (required)

Yes A compliant audit report must accompany this application.

No Go to Part H

CER-RET-020


Audit report (required if any)

Attach an audit report that complies with regulation 22UB.

Guidelines relating to the audit report are available on the Clean Energy Regulator website7.

Attached

57. Auditor type (required if any)

Please check all relevant boxes concerning the auditor who provided the audit report.

An authorised audit company under section 1299C of the Corporations Act 2011

Person who is a registered auditor under section 1280 of the Corporations Act 2001

A ‘registered greenhouse and energy auditor’ within the meaning of the National Greenhouse and Energy Reporting Act 2007 who is registered in Category 2 or 3 under the Nation Greenhouse and Energy Reporting Regulations 2008.

58. Is the auditor an independent registered auditor? (required if any)

An independent registered auditor means a registered auditor who is independent of the application or applicants to the extent that a conflict of interest (within the meaning of the National Greenhouse and Energy Reporting Regulations 2008) does not arise in relation to the auditing of the application.

Yes

No

59. Was an audit report prepared which deals with the site’s 2014–15 quantity of relevant product? (required)

Yes

No

If yes, you must attach a copy of the audit report.

Attached

7 http://www.cleanenergyregulator.gov.au/NGER/For-auditors/Audit-determination-handbook

http://www.cleanenergyregulator.gov.au/NGER/For-auditors/Audit-determination-handbook

CER-RET-020


Part H: Declaration

This section must be signed by the applicant, if an individual, or by a representative of the applicant on their behalf.

By signing below, the signatory

a) declares that the information supplied in this form is true and correct and that he/she is authorised to make this application on behalf of the applicant named in the form;

b) acknowledges that giving false or misleading information is a serious offence and carries penalties under the Criminal Code Act 1995;

c) acknowledges that the Regulator may amend an exemption certificate in accordance with the provisions of section 46C of the Renewable Energy (Electricity) Act 2000 (the Act);

d) acknowledges that the Regulator can seek to verify information provided under the Act or check compliance with the Act by consent or monitoring warrant. Authorised officers of the Clean Energy Regulator can request or require that information be provided as part of this process;

e) acknowledges that failure to provide information to an authorised officer when requested under monitoring warrant constitutes an offence with a maximum penalty of imprisonment for 6 months under section 113 of the Act;

f) acknowledges that knowingly providing false or misleading evidence is an offence with a maximum penalty of imprisonment for 12 months under section 125E of the Act;

g) acknowledges that the Regulator must publish information about exemptions on its website, as specified under section 38C of the Act;

h) acknowledges that the Act (section 160) and the Renewable Energy (Electricity) Regulations 2001 (regulation 22ZT) impose an obligation with respect of the retention of records relating to this form; and

i) acknowledges that protected information provided in the application will be treated in accordance with the secrecy provisions of the Act and the Clean Energy Regulator Act 2011 (noting that these may allow information to be divulged to specified persons or bodies under specified circumstances).

Full name of signatory

Title/position

Organisation (if applicable)

Signature

Day (dd) Month (mm) Year (yyyy)

Signature date

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Part I: Statutory declaration

60. Verification of application by statutory declaration (required)

You must complete the statutory declaration provided on the next page to verify that the information in this application is accurate and complete.

The statutory declaration must be made by one of the following persons:

A director of the applicant

The applicant’s chief executive officer

The applicant’s chief financial officer

The applicant’s company secretary

It is important to ensure that:

The full name, address and occupation of the person making the declaration are included in item 1

The full name, qualification and address of the person before whom the declaration is made are included at item 8.

Attach the original signed statutory declaration in accordance with the Statutory Declarations Act 1959. Tick the box to confirm the declaration has been attached.

Documentary evidence type Attached

Statutory declaration

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Commonwealth of Australia

STATUTORY DECLARATION

Statutory Declarations Act 1959

1 Insert the name,

address and

occupation

of person making the declaration

1 I,

make the following declaration under the Statutory Declarations Act 1959:

2 Matter declared to in numbered paragraphs

2 I state that, based on all reasonable steps having been taken to verify the information in this application, this

application is accurate and complete as far as I know.

3

I understand that a person who intentionally makes a false statement in a statutory declaration is guilty of an offence under section 11 of the Statutory Declarations Act 1959, and I believe that the statements in this declaration are true in every particular.

4 Signature of person making the declaration

4

5 Place

6 Day

7 Month and year

Declared at 5 on

6 of

7

Before me,

8 Signature of person before whom the declaration is made (see over)

8

9 Full name,

qualification and

address

of person before whom the declaration is made (in printed letters)

9

A person who intentionally makes a false statement in a statutory declaration is guilty of an offence, the punishment for which is imprisonment

for a term of four years. See section 11 of the Statutory Declarations Act 1959.

Chapter 2 of the Criminal Code applies to all offences against the Statutory Declarations Act 1959. See section 5A of the Statutory Declarations

Act 1959.

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Statutory declaration criteria

A statutory declaration under the Statutory Declarations Act 1959 may be made before

a) (1) a person who is currently licensed or registered under a law to practise in one of the following occupations:

Chiropractor

Dentist

Legal practitioner

Medical practitioner

Nurse

Optometrist

Patent attorney

Pharmacist

Physiotherapist

Psychologist

Trade marks attorney

Veterinary surgeon

b) (2) a person who is enrolled on the roll of the Supreme Court of a State or Territory, or the High Court of Australia, as a legal practitioner (however described), or

c) (3) a person who is in the following list:

Agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public

Australian Consular Officer or Australian Diplomatic Officer (within the meaning of the Consular Fees Act 1955)

Bailiff

Bank officer with 5 or more continuous years of service

Building society officer with 5 or more years of continuous service

Chief executive officer of a Commonwealth court

Clerk of a court

Commissioner for Affidavits

Commissioner for Declarations

Credit union officer with 5 or more years of continuous service

Employee of the Australian Trade Commission who is:

a. in a country or place outside Australia; and

b. authorised under paragraph 3 (d) of the

Consular Fees Act 195, and

c. exercising his or her function in that place

Employee of the Commonwealth who is:

d. in a country or place outside Australia; and

e. authorised under paragraph 3 (c) of the

Consular Fees Act 1955, and

f. exercising his or her function in that place

Fellow of the National Tax Accountants’ Association

Finance company officer with 5 or more years of continuous service

Holder of a statutory office not specified in another item in this list

Judge of a court

Justice of the Peace

Magistrate

Marriage celebrant registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961

Master of a court

Member of Chartered Secretaries Australia

Member of Engineers Australia, other than at the grade of student

Member of the Association of Taxation and Management Accountants

Member of the Australasian Institute of Mining and Metallurgy

Member of the Australian Defence Force who is:

g. an officer; or

h. a non-commissioned officer within the

meaning of the Defence Force Discipline Act

1982 with 5 or more years of continuous

service; or

i. a warrant officer within the meaning of that

Act

Member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants

Member of:

j. the Parliament of the Commonwealth; or

k. the Parliament of a State; or

l. a Territory legislature; or

m. a local government authority of a State or

Territory

Minister of religion registered under Subdivision A of Division 1 of Part IV of the Marriage Act 1961

Notary public

Permanent employee of the Australian Postal Corporation with 5 or more years of continuous service who is employed in an office supplying postal services to the public

Permanent employee of:

n. the Commonwealth or a Commonwealth

authority; or

o. (b) a State or Territory or a State or Territory

authority; or

p. a local government authority;

with 5 or more years of continuous service who is

not specified in another item in this list

Person before whom a statutory declaration may be made under the law of the State or Territory in which the declaration is made

Police officer

Registrar, or Deputy Registrar, of a court

Senior Executive Service employee of:

q. the Commonwealth or a Commonwealth

authority; or

r. a State or Territory or a State or Territory

authority

Sheriff

Sheriff’s officer

Teacher employed on a full-time basis at a school or tertiary education institution.

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Application checklist

Ensure that you have completed all the mandatory sections and any other applicable sections below and that all attachments have been provided with this application. Check the box when you have completed the task beside it.


Tick Task Number attached

Completed all required fields. N/A

Section A1: Schedule of contract for electricity supply (if applicable).

Section A4: Schedule of contract for electricity supply (if applicable).

Section A5: Copy of written notice (if applicable).




Part C: Liable entity






All necessary approvals to support EITE activity (if applicable).




Site map/s (if applicable)

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Appendix A: EITE activity group (if applicable).

Appendix B: New entrant product (if applicable).

Appendix C: Expected additional production (if applicable).

Appendix D: Quantity of relevant product (if applicable).




Audit report (if applicable)

Part H: Declaration



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Additional information

Definitions

For the purposes of this form:

Act means the Renewable Energy (Electricity) Act 2000

Applicant means a prescribed person that makes an application for an exemption

ASP is the quantity of relevant product from question 52 (and Appendix C if applicable)

EASP2015-16 Is the quantity of new or expected additional production for the 2015–16 financial year

EASP2014-15 is the quantity of new or expected additional production for the 2014–15 financial year as assessed in the 2015 exemption certificate application (if any)

EITE activity means an emissions-intensive trade-exposed activity as defined in Schedule 6 to the Regulations

EP is the electricity baseline from Schedule 6 to the Regulations (summarised in Appendix E)

Executive officer means, in relation to a body corporate:

a director of the body corporate, or

the chief executive officer (however described) of the body corporate, or

the chief financial officer (however described) of the body corporate, or

the secretary of the body corporate.

Exemption certificate

means exemption certificate

G is ratio of liable/total electricity from question 34(e)

k2016 is the exemption assistance rate of 100% using the formula of regulation 22ZA(1)

Liable entity has the same meaning as in the Act

NGER Act means the National Greenhouse and Energy Reporting Act 2007

Operational control has the same meaning as in the NGER Act

Person Means any of the following:

a body corporate

a trust

a corporation sole

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a body politic

a local governing body, or

an individual.

Regulations means the Renewable Energy (Electricity) Regulations 2001.

Relevant product means:

in relation to an application for an exemption certificate – a product or substance that is identified in the application as meeting the requirements specified in Division 3 of a Part in Schedule 6 to the Regulations as the basis for the issue of the certificate, and

in relation to an exemption certificate that has been issued – a product or substance that meets the requirements specified in Division 3 of a Part in Schedule 6 to the Regulations as the basis for the issue of the certificate.

Site means the site at which the EITE activity is wholly or partly carried on

SP2013-14 is the quantity of relevant product produced in the 2013–14 financial year

SP2014-15 is the quantity of relevant product produced in the 2014–15 financial year

Assessment of the application

Once a complete application has been received, the Clean Energy Regulator will consider the application and the supporting documentation provided in accordance with the provisions of the legislation. If the application is a valid application, the Clean Energy Regulator will issue an exemption certificate to the applicant. The Clean Energy Regulator may also seek further information from the applicant when assessing the application.

To enable quick assessment of your application, please ensure that all details provided in this application are accurate, up to date and complete. An application will only be assessed if the required information is provided.

In general, the Clean Energy Regulator must issue an exemption certificate within 60 days of receiving the application or if the Clean Energy Regulator requires further information to be provided, within 45 days of the applicant providing further information. The Clean Energy Regulator will notify the applicant in writing of the decision on the application.

Publishing of information

The Clean Energy Regulator must publish information about an exemption certificate on the Clean Energy Regulator website, in accordance with section 38C of the Renewable Energy (Electricity) Act 2000 and regulation 22E of the Renewable Energy (Electricity) Regulations 2001.

This information includes the name of each person to whom an exemption certificate is issued and the EITE activity set out in the exemption certificate, and the total amount of exemptions given for each EITE activity.

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Protection of information

The Clean Energy Regulator is bound by the secrecy provisions of Part 3 of the Clean Energy Regulator Act 2011 (Clean Energy Act) for the information it collects in relation to this application and also by the Privacy Act 1988 in regard to personal information it collects.

Privacy statement

'Personal information' is defined in the Privacy Act 1988 to mean information or an opinion about an identified individual, or an individual who is reasonably identifiable:

(a) whether the information or opinion is true or not; and

(b) whether the information or opinion is recorded in a material form or not.

The collection of personal information relating to this application is authorised by the Renewable Energy (Electricity) Act 2000, the Renewable Energy (Electricity) Regulations 2001, the National Greenhouse and Energy Reporting Act 2007 and the National Greenhouse and Energy Reporting Regulations 2008.

Personal information collected in relation to this application will be used for the purposes of assessing the application, auditing compliance, enforcement of relevant laws, regulations and legislative rule, the performance of our statutory functions and for related purposes. We will also use the personal information which you provide for our administrative purposes, for example, to pre‐populate other Clean Energy Regulator forms which you wish to fill out online in the future, and for improving our service delivery to you. We cannot process the application if we do not collect relevant personal information.

The Clean Energy Regulator’s Privacy Policy contains information about the agency’s procedures for handling personal information including how a person can access their personal information held by the agency, and how to seek correction of such information. The Privacy Policy also contains information about how to complain about a breach of the Australian Privacy Principles. The Clean Energy Regulator’s Privacy Policy can be found on the Clean Energy Regulator website8

.

Accessibility disclaimer

The Clean Energy Regulator has worked to ensure that this document is accessible but please contact us to obtain an alternative version if you are having difficulty or you have specific accessibility needs.

Please call 1300 553 542 or email the name of the form and your needs to [email protected].

Disclosure of information

The Clean Energy Regulator is only able to disclose information relating to this application (including personal information) in accordance with the Clean Energy Regulator Act 2011, the Privacy Act 1988 or as otherwise required by law. The circumstances in which such information may be disclosed include:

disclosure for the purposes of a climate change law or for the purposes of the performance of our functions under a climate change law

disclosure to the Minister

8 http://www.cleanenergyregulator.gov.au/

http://www.cleanenergyregulator.gov.au/

mailto:[email protected]

http://www.cleanenergyregulator.gov.au/

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disclosure of summaries or statistics if those summaries or statistics are not likely to enable the identification of a person

disclosure to certain bodies where the Chair of the Clean Energy Regulator is satisfied that disclosure will assist those bodies in the performance of their functions or powers, including the Australian Securities and Investment Commission, and the Australian Competition and Consumer Commission, and

disclosure for the purposes of enforcement of the criminal law, enforcement of a law imposing a pecuniary penalty or for protection of the public revenue, if the Chair of the Clean Energy Regulator is satisfied that disclosure is reasonably necessary for such purpose.

Documents

2016 Exemption certificate form - Clean Energy · PDF fileV2.0 12/02/2016 2016 Application for exemption certificate 1 of 31 ... Declaration Part I: Statutory ... using a separate