Zero Emission Vehicle Credit Transfer Form
Attachment F
ZeroEmission Vehicle (ZEV) Credit Transfer Form
Complete and Submit to:Ms. Krista Eley, Program Manager, ZEV Bank
California Air Resources Board, MSCD/STTB
P.O. Box 2815, Sacramento, California95812
Date of Transfer
/ This document certifies that pursuant to Section 1962.1, Title 13, California Code of Regulations, an agreement executed between Company A and Company B on the Date of Transfer contains the following terms of transfer:I. Transfer of Zero-Emission Vehicle Credits FROm transferor (A) to transferee (B)
Model Year Earned / Type of Vehicle(NEV, 0CA, ICA,I.5CA, IICA, IIICA, IVCA, VCA, 0XX, IXX, I.5XX, IIXX, IIIXX, IVXX, VXX, Enhanced ATPZEV,
AT PZEV and PZEV) / Number of Credits
(g/mi NMOG) / Transportation System
Credits (Y/N)
I declare under penalty of perjury that all information provided herein are true and correct, to the best of my knowledge and belief.
II. TransferOR (A)
Account Holder – Company Name / *Account IDAuthorized Company Representative Name – First, MiddleI., Last (please print) / Phone Number
Authorized Company Representative Signature (A) / Date
III. Transferee (B)
Account Holder – Company Name / *Account IDAuthorized Company Representative Name – First, MiddleI., Last (please print) / Phone Number
Authorized Company Representative Signature (B) / Date
*Please contact the ZEV Bank Program Manager for your Account ID.
FOR ARB USe ONLY:
Entered By (Please print name and title) / Initials / Date Received / Date Recorded
Attachment F
Instructions and Definitions for the ZEV Credit Transfer Form
Definitions
Transferor / Party giving credits.Transferee / Party receiving credits.
Account Holder/ Account ID / Account Holder/Account ID – Company Name and Account Holder Identification. Please contact the ZEV Bank Program Manager for an Account ID.
Model Year / Year in which ZEV credits were earned by manufacturer. For Enhanced Advanced Technology Partial ZEV (AT PZEVs), AT PZEVs and PZEVs enter null.
Type of Credit / ZEV Tier – Tier type including: NEV, 0CA, ICA, I.5CA IICA,
IIICA, IVCA, VCA, 0XX, IXX, I.5XX IIXX, IIIXX, IVXX, VXX
where XX is the abbreviation of 177 State.
Enhanced Advanced Technology Partial ZEV (Enhanced AT PZEV)
Advanced Technology Partial ZEV (AT PZEV)
Partial ZEV (PZEV)
Number of Credits / Total number of credits transferring in grams/mile
Non-Methane Organic Gas (g/mi NMOG).
Transportation System Credits / Credits earned in a Transportation System Project. These credits are only available for ZEVs (non-NEV),
Enhanced ATPZEVs, ATPZEVs, and PZEVs.
Example
I. Transfer of Zero-Emission Vehicle Credits FROm transferor (A) to transferee (B)
Model Year Earned / Type of Vehicle(NEV, 0CA, ICA, I.5CA, IICA, IIICA, IVCA, VCA, 0XX, IXX, I.5XX, IIXX, IIIXX, IVXX,
VXX, Enhanced ATPZEV,
AT PZEV, PZEV) / Number of Credits
(g/mi NMOG) / Transportation System
Credits (Y/N)
1 / 2008 / IICA / 15.3 / Y
2 / 2008 / IINJ / .39 / N
3 / 2009 / NEV / 3.4 / N
4 / null / PZEV / 6.8 / N
STATE OF CALIFORNIA
AIR RESOURCES BOARD / ZEV Credit Reporting and Tracking System
MSCD/STTB/ZEV_105
MAC 2011-02
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