CER-RET-028

FORM
CER-RET-028
V2.129/11/2016

2017Application for an exemption certificate–
change of liable entity

under the Renewable Energy (Electricity) Act 2000

Purpose of this form

Under the Renewable Energy (Electricity) Act 2000 (the Act), electricity used in carrying out emissions-intensive trade-exposed (EITE) activities may be eligible for exemption from Large-scale Renewable Energy Target and Small-scale Renewable Energy Scheme liability. Exemption from liability is granted to the prescribed person carrying out the EITE activity in the form of an exemption certificate.

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

If the RET liable entity changes during the 2017 year, this form may be used to apply for a second or third exemption certificate in relation to the new RET liable entity.

Eligibility

Under regulation 22L of the Renewable Energy (Electricity) Regulations 2001(the Regulations),a person who has been granted an exemption certificate for an EITE activity carried out in 2017 may apply to the Clean Energy Regulator for a second or third exemption certificateif,during the 2017 year, the RET liable entity namedon the existing exemption certificate ceases to supply electricity to the site detailed on the certificate, and a newRET liable entity begins supplying electricity to the site.

Making a valid application for an exemption certificate

The Clean Energy Regulator will only assess validly made applications for exemption certificates. Validly made applications must be accurately completed and contain all information required in the application forms in accordance with relevant provisions in the Act and the Regulations. This includes any documentation that supports the application.

An exemption certificate will not be issued if the application is not validly made.

To ensure that an application for an exemption certificate is a validly made application, applicants should familiarise themselves with relevant parts of the Act[1] and the Regulations[2] before applying for an exemption certificate. Applicants may:

  • seek independent advice before submitting an application, and
  • discuss their application with the Clean Energy Regulator

before applying for an exemption certificate.

Applicants should ensure they allow sufficient time to complete their application (including for seeking independent advice, or after reviewing this form and the guidelines, discussing with the Clean Energy Regulator).

Where applications are not validly made

If an application is not validly made, the Clean Energy Regulator will advise the applicant in writing that the application is not validly made and the reasons why it is not a validly made application:

  • The applicant may re-submit an application for assessment before the legislated deadline.
  • Where applications are not validly made and the deadline has passed, no further assessment will be undertaken.

It is recommended that you submit your application early in 2017 to allow sufficient time to assess whether your application is validly made.

The Clean Energy Regulator will not issue Requests for Further Information for applications not validly made.

Submitting this form

The 2017 Application for an exemption certificate - change of liable entity form must be received by the Clean Energy Regulator on or before31 December 2017. Please note that this deadline may be affected by the Acts Interpretation Act 1901, which, among other things, applies where a deadline falls on a public holiday or a weekend.

It is recommended that you submit your application early in 2017 to allow sufficient time to assess whether your application is validly made.

By post

Post your completed application with any accompanying documentation to:

Clean Energy Regulator
Industry Assistance Schemes
GPO Box 621
Canberra ACT 2601

By fax

You can submit your completed application by fax to 02 6159 3886.

By email

You can submit your completed application by email:
.

If you choose to submit by email or fax, you will also need to submit a hard copy original of the statutory declaration in Part F by post. The entire form does NOT need to be posted.

Regardless of how you lodge your completed application, you should keep a copy of all parts of the signed form submitted to the Clean Energy Regulator for your records.

Instructions for completing this form

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

You must complete and submit:

  • Part A: Prescribed person - change of RET liable entity
  • Part B: Applicant details
  • Part C: RET liable entity
  • Part D: Calculation for splitting exemption between two or more RET liable entities
  • Part E: Declaration
  • Part F: Statutory declaration

If there is insufficient 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:

  1. printing thisapplication form and filling it in by hand, or
  2. saving thisapplication form and filling in an electronic copy.

Note that if you choose the second option, you will also need to print certain sections in order to sign them.

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 use either ✔ or ✘.
Go to / Where you see an instruction, 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 or 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) below.
Mandatory questions / If the question is mandatory, required is added to the end of the question.
When a question is mandatory upon certain conditions being met, required if any, is added to the end of the question.
 / This symbol indicates what to do next.
 / This symbol indicates additional useful guidance.
 / This symbol advises that more than one entry may be required and you may need to photocopy or print the section or fill in a duplicate.
 / This symbol advises that supporting documentation may need to be attached.

Help filling in this form

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

Legislation

A reference to a legislative provision in this form is a reference to a provision of the Renewable Energy (Electricity) Regulations 2001, unless stated otherwise.

Part A:Prescribed person- change of RET liable entity

  1. Please explain briefly how you are a prescribed person under regulation 22L. (required)

Explanation
  1. Were you issued an exemption certificate in relation to an EITE activity and site in 2017? (required)

Yes
No / You do not meet the criteria to apply for an exemption certificateas a prescribed person under regulation 22L
  1. What is the identification number of the exemption certificate?(required)

This is the number on the certificate issued by the Clean Energy Regulator (e.g. 2017-XXXX-0075-A)

Exemption Certificate ID
  1. During 2017, did the RET liable entity stated on the exemption certificate cease to be the RET liable entity in relation to the electricity consumed at the site? (required)

Yes
No / You do not meet the criteria to apply for anexemption certificate as a prescribed person under regulation 22L
  1. Who is the new RET liable entity in relation to the electricity consumed at the site? (required)

New RET liable entity

Part B:Applicant details

Applicant details

Please provide details relating to the applicant.

  1. Applicant name.(required)

This is the name that appears on the Australian Business Register (see ABR website to check: ).

Name
  1. Trading name. (requiredif any)

Provide the trading name, if any.

Name
  1. 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
  1. Identifying details.(required)

You must provide one of the following for the applicant in order of precedence: ABN, ACN, 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.

Are the trading name and the street address the same as those provided at questions 7and 8?

Yes / Go to question 10
No / Provide details below
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.

  1. Primary contact person’s details.(required)

Provide the person’s full name.

Title
(e.g.Ms, Mr, Mrs, Dr)
Given name(s)
Last name

Provide the person’s position.

Position

Provide the person’s contact details.

Phone number
Email

Secondary contact person

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

  1. Secondary contact person’s details.(required)

Provide the person’s full name.

Title
(e.g. Ms, Mr, Mrs, 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.

  1. Executive officer details.(required)

Provide the executive officer’s position.

Position

Provide the executive officer’s full name.

Title
(e.g. Ms, Mr, Mrs, Dr)
Given name(s)
Last name

Provide the executive officer’s contact details.

Phone number
Email

Emissions-Intensive trade-exposed activity

In this section you need to identify the EITE activity carried out at the site relating to this application

  1. EITE activity details. (required)

Identify the EITE activity to which this application relates.

Eligible EITE activities arespecified in Schedule 6 of the Regulations and summarised in Appendix E to this form.

Name of EITE activity
  1. How will the EITE activitybe carried out at the site?(required)

If the information has not already been provided to the Clean Energy Regulator, describe how the EITE activity will be carried out in the context of total production at the site in 2017, including any relevant approvals, and state how requirements relating to the relevant activity specified in Schedule 6 ofthe Regulations are met. Check one of the boxes below.

If insufficient space please provide additional information as an attachment.

All relevant informationwas provided to the Clean Energy Regulator with a previous exemption certificate application and no changes have occurred to how the EITE activity is carried out at the site that is reflected in that information.
How the EITE activity is carried out at the site (if not already provided)

Quantity of relevant product

In this section you will provide details of the quantity of relevant product for 2015-16 in relation to the EITE activity carried out at the site. Provide additional information as attachments if required.

  1. If the information has not already been provided to the Clean Energy Regulator, provide details of each relevant product in relation to the site.(required)

Complete and attach a copy of Appendix D for each relevant product, unless this information has already been submitted to the Clean Energy Regulator in a previousexemption certificate application.

All relevant informationwas provided to the Clean Energy Regulator with a previous exemption certificate application and no changes have occurred to the relevant product reflected in that information
Attached

Part C:RET liable entity

The Clean Energy Regulator may contact the RET liable entity about this application; we will contact you before this occurs.

RET liable entity details

Provide details of the new RET liable entity in relation to the electricity consumed at the site, whichthe exemption certificate will relate to.

  1. New RETliable entity details.(required)

Provide the name of the RET liable entity.

This is the name that appears on the Australian Business Register (see ABR website to check: ).

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
  1. Specify the circumstances in which the old RET liable entity ceased to be the RET liable entity.(required)

Details of the change of RET liable entity
  1. Provide evidence of the date on which the old RET liable entity ceased to be the RET liable entity and the date on which the new RET liable entity became the RET liable entity.(required)

Attach evidence of dates, such as the schedule to the new electricity supply contract.

Attached
  1. Provide evidence that both the old and new RET liable entities have been informed of the application for anexemption certificate.(required)

Attach evidence that both RET liable entities have been informed of the application.

Attached

Part D:Calculation for splitting exemptionbetween two or more RET liable entities

Calculate the expected exemption for the new RET liable entity for 2017.

  1. What is the amount of the exemption set out in the issuedexemption certificate in relation to the old RET liable entity? (required)

Amount ofexemption / MWh (OL)
  1. What is the number of days in 2017 that the new RETliable entity will be the RET liable entity?(required)

Days / MWh (D)
  1. What is the number of days in 2017that the old RET liable entity was the RET liable entity?(required)

Days / MWh (OLD)
  1. Is this application in relation to a third RET liable entity for 2017in relation to the EITE activity and site? (required)

Yes / Go to question 25
No / Go to question 24
  1. Estimate the exemption you expect to be set out in the exemption certificate for the new (second) RET liable entity for 2017in relation to the EITE activity and site, based on the method of regulation 22ZF(required)

Please calculate the exemption using the formula: .

Estimated amount of exemption / MWh

You have completed this section. Go directly to Part E. 

  1. Estimate the exemption you expect to be set out in the exemption certificate for the new (third) RET liable entity for 2017in relation to the EITE activity and site, based on the method in regulation 22ZF(required)

Please calculate the exemption using the formula:

Estimated amount of exemption / MWh

Part E: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 declares and acknowledges that:

a)they have the legal capacity and authority to make the application on behalf of the applicant;

b)acknowledges that giving false or misleading information is a serious offence and carries penalties under the CriminalCodeAct1995;

c)all information provided in, or in relation to, this form is, having made all reasonable enquiries, complete, true and correct and not misleading by inclusion or omission;

d)the applicant authorises the Clean Energy Regulator to copy, record, use or disclose any of the information provided in relation to this application for the purposes of processing the application, monitoring compliance, enforcement of laws, the performance of the Clean Energy Regulator’s statutory functions and for related purposes subject to the requirements of relevant laws, in particular the Privacy Act 1988 and Part 3 of the Clean Energy Regulator Act 2011; and

e)the personal information provided in this application may also be copied, recorded, used or disclosed by the Clean Energy Regulator for its administrative purposes, for example, to pre-populate other Clean Energy Regulator forms filled out online in the future, and for improving the Clean Energy Regulator’s service delivery to the applicant.

Full name of signatory
Title or position
Organisation
(if applicable)
Signature
Day (dd) / Month (mm) / Year (yyyy)
Signature date

Part F:Statutory declaration

  1. Verification of the application by a statutory declaration. (required)

A statutory declaration must be made that verifies, for the applicant, that based on all reasonable steps having been taken to verify the information in this application, the application is accurate and complete as far as the verifying person knows.

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 made in accordance with the Statutory Declarations Act 1959.

Commonwealth of Australia
STATUTORY DECLARATION
Statutory Declarations Act 1959
1Insert the name, address and occupation of person making the declaration / 1 I,
make the following declaration under the Statutory Declarations Act1959:
2Set out 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.
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.
3Signature of person making the declaration / 3
4Place
5Day
6Month and year / Declared at 4 on 5 of 6
Before me,
7Signature of person before whom the declaration is made (see over) / 7
8Full name, qualification and address of person before whom the declaration is made
(in printed letters) / 8

Note 1: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.