FORM FEO-20 APPLICATION TO STATE FOR PETROLEUM PRODUCT SUPPLY ASSISTANCE A. WHO MAY USE THIS FORM a) For temporary hardship relief - Any end user or supplier of propane, gasoline, middle distillate (including kerosene, #2 heating oil, and diesel fuel), or residual oil may use this form to request a temporary hardship allocation from the state set-aside. b) For permanent supply adjustments - End users of any petroleum product who are not wholesale purchasers may use this form to request an assignment of supplier or increased supply volume. Wholesale purchasers must use Form FEO-17 for requesting permanent supply adjustments or assignment of supplier. Wholesale purchasers are defined as: a) Agricultural production users who use over 20,000 gallons of product per year; b) Multi-family residences which use over 50,000 gallons of product per year; or c) All others who purchase over 84,000 gallons per year, whether for their own use or for resale. B. HOW TO FILL OUT THE FORM Block 1 - Fill in your name, address, and telephone number. If you use a company name, enter the name of the person in your firm who may be contacted about the application. Block 2 Block 3 Block 4 Block 5 - Indicate whether you are an end user, supplier, or other category of applicant. - If you have previously filled out a Form FEO-17 requesting either an assignment of supplier or an adjusted base period volume, indicate by checking the appropriate box, and attach a copy of the Form FEO-17. Enter your case number if one has been assigned in connection with your Form FEO-17. - Indicate whether the application is for temporary hardship relief or for a permanent adjustment by checking the appropriate box. Block 6 - If you are applying for a temporary hardship allocation, fill in the quantity of fuel and the delivery date(s) desired. - If you are seeking a permanent adjustment or an assignment of supplier, enter the quantity of product you will require for each of the next twelve months, in gallons. Block 8 - If you already have a supplier enter his name, address, telephone number, and person to contact, and check the box labelled “existing supplier". If you have two or more suppliers, fill out a separate block for each supplier, attaching additional sheets if necessary. If you have no supplier, you are required to contact two suppliers who would be able to delivery the product you require, and who may be contacted by the state officer if your request is approved. In this case, fill in both blocks and check "potential supplier" in each block. Block 9 - This block is used to justify your application. Explain here the nature of your hardship, or why you need more product than your supplier is delivering, or why you need a new supplier. Attach additional pages if necessary to fully explain your application. Block 10- Explain here the specific end uses for the product you are requesting. If you are a supplier applying for your customers, detail their intended end uses. If the fuel is to be used for space heating, describe the building or buildings, and give the area of floor space of the rooms or buildings. If the fuel is to be used in an industrial process or for other machine use, identify each machine and state its fuel consumption rate and the number of hours or days per week the machine is to be used. If the fuel is for transportation, identify the type of vehicle, the approximate number of miles to be driven, and the purpose of the transportation. The more specific you can be in explaining the use of the requested fuel, the more quickly the state allocation officer can decide the merits of your case. Attach extra pages if necessary. Block 11 - You must sign and date the form, certifying the accuracy of the information in the form, and certifying that, if the application is granted, the product will be used only for the specific purposes stated on the form. Section 211.21 of the allocation regulations requires that you also certify that you have an energy conservation program in effect. C. FOR STATE USE - HOW TO PROCESS THE APPLICATION 1. Determine if the application is for a temporary hardship which can be relieved from the state set-aside. If so, the case should be resolved in accordance with state procedure, and the outcome recorded on Form FEO-21. "Action on Application for Exceptional Hardship Assistance." If approved, the Form FEO-21 then becomes the official order requiring delivery of fuel to the applicant when presented to the appropriate supplier. 2. If the application is not for a temporary hardship, but rather for a permanent adjustment or assignment of supplier, determine if the applicant is a wholesale purchaser according to the definition in Part A above. Wholesale purchasers may not use this form (FEO-20) for permanent adjustments, but must use Form FEO-17 instead. 3. States are encouraged to resolve requests from qualified applicants for assignment of supplier or for permanent adjustment to supply volumes, in accordance with the policy adopted by each state and with FEO regulations. Any application which cannot be resolved in accordance with state procedure may be referred to the regional office of the FEO, along with the results of the state's investigation and with the state's recommendations, if any. Approval of application of above end user/wholesale purchaser is recommended with the following changes: ACTION OF FEDERAL ALLOCATION OFFICER: (where required by state law or procedures) Application of above end user/wholesale purchaser is approved with the following changes: The supplier designated above is hereby directed to furnish the end user/wholesale purchaser also noted above with the following: This quantity will be supplied in accordance with arrangements agreed upon by supplier and purchaser. Date/Period FEDERAL ENERGY OFFICE SUPPLIER'S MONTHLY ALLOCATION WORKSHEET (FEO-22) INSTRUCTIONS PART I WHO SHOULD COMPLETE: All suppliers of products covered by the program should complete a separate Form FEO-22, Part I, for each product supplied each month, and should maintain these records on file for possible inspection by FEO. There are special, separate instructions for propane. HOW TO COMPLETE: PARTI I-1. Month Covered: Enter month and year covered by the form. 1-2. Product Type: Enter the type of product covered by the form. (Use a separate form for each different product). 1-3. Company Name and Brand Name of Product (a) Enter corporate name of supplier completing form. (b) Enter brand name of supplier completing form. 1-4. Company Address: Enter company address including zip code. NOTE: Items #5 and #6 to be completed by Refiner/Suppliers, Importer/Suppliers, Gas Processing Plants, and 1-5. Estimated Total Production, Imports, and Inventory Adjustments (a) Enter total in 000 gals.* I-6. State Set-aside (if applicable) (a) Set-aside percentage - Enter set-aside percentage for fuel type covered, as determined by the FEO. (b) Set-aside gallons - Enter set-aside gallons (equal to set-aside percentage multiplied by Item #5.) (c) Set-aside unused from previous month - Enter 000 gals. of set-aside from previous month which were not allocated. 1-7. Total Allocable Supply (a) Refiner/Supplier, Importer/Supplier, Gas Processing Plants and Petrochemical Plants enter Item #Sa minus Item 6b plus Item 6c. Wholesale purchasers who are also suppliers, enter sum of allocations from your suppliers. I-8. Allocation Requirements (a) Enter sum of Column #5, Part II I-9. Agricultural Production Requirements (a) Enter needs for Agricultural Production as defined in the regulations. I-10. Net Allocable Supply (a) Enter the amount for line 7a minus 9a. I-11. Net Allocation Requirements (a) Enter the amount for line 8a minus 9a. I-12. Allocation Fraction (a) Enter the result from the division of line 10a by line 11a. (b) This fraction will be applied in Part II to determine each customer's share, except for agricultural production which will receive 100%. *Thousands of gallons FEDERAL ENERGY OFFICE SUPPLIER'S MONTHLY ALLOCATION WORKSHEET (FEO-22) INSTRUCTIONS PART II WHO SHOULD COMPLETE: All suppliers of products covered by the program should complete a separate Form FEO-22, Part II, for each product supplied each month, and should maintain these records on file for possible inspection by FEO. There are special, separate instructions for propane. HOW TO COMPLETE: 1-1. Customer Name and Identification: Enter the name and account number (or other identification) for each customer. Customers in the same end-use category (such as space heating, agricultural production, etc.) may be grouped together in a single entry on the worksheet, providing your own records show, at a minimum, the quantity of fuel delivered, the dates of each delivery, and the end-use category for each customer. If you group your customers on the worksheet, your own individual customer records must be available for audit by the FEO in support of the worksheet. II-2. Base Period Volume - Enter Base Period Volume in 000 gals.* for each purchaser or group of purchasers. 11-3. Adjusted Base Period Volume - Enter adjusted base period volume for each purchaser or group of purchasers. For end-use purchasers whose allocation is based on current requirements, substitute current requirements in 000 gals. II-4 Allocation Level - Enter percentage figure for each customer or group of customers according to the end-use category. For customers who resell product, the allocation level will always be 100%. II-5. Allocation Requirements - Enter the result of Column #4 multiplied by Column # 3. Compute the total of this column for use in calculating allocation fraction (see Part I, Item 8). II-6. Allocation Fraction - Enter ratio of Net Allocable Supply divided by Net Allocation Requirements (Part I, Item 12a). For agriculture use 1.00 (100%). II-7. Customer's Share - Agricultural production will be supplied 100%. For others, enter the result of supplier's allocation fraction (Column #6) multiplied by Column #5. This is the amount which the supplier may deliver to each purchaser or group of purchasers. II-8. Actual Volume Supplied - Enter actual quantity delivered each month in 000 gals. *Thousands of gallons Who Should Complete FEDERAL ENERGY OFFICE SUPPLIERS MONTHLY ALLOCATION WORKSHEET (FEO-22) SPECIAL INSTRUCTIONS FOR PROPANE SUPPLIERS AND RESELLERS All suppliers who sell propane to an end-user All resellers who sell propane to an end-user Note: The information entered on this form will be used in completing Form FEO-102 (Propane Reseller Monthly Report). Note: Where supplier acts as reseller, this form and FEO-102 must be completed and totaled with all FEO-102's received from other suppliers and/or resellers in order to complete Form FEO-100. Fach supplier/reseller should fill out part II of the form initially, as columns 1 through 5 will be used to complete FEO Form-102 in reporting to your source of propane your priority requirements. Step 1 Step II Step III Step IV Step V Step VI. - First, list in Column 1 all of your priority customers as designated in Section 211.83 of the Mandatory Petroleum - If the customer has an allocation level of "100% current use", enter the total gallons of this requirement for this Determine the total allocation requirements for cach priority customer by multiplying the volume in Column 3 by the allocation level percentage in Column 4, and enter this number in Column 5. Total Column 5. This total will be reported to your supplier as your monthly priority requirements. Next, list all your non-priority customers in Column 1. In some cases, customers may be listed as both priority and Enter for each non-priority customer the volume used during the same month of the period October 3, 1972 to Step VII Complete Items I-1 to 1-4 as follows: I-1. Month Covered: Enter month and year covered by the form. I-2. Product Type: Enter the type of product covered by the form. (Use a separate form for each different product). 1-3. Company Name and Brand Name of Product: (a) Enter corporate name of supplier completing form. (b) Enter brand name of supplier completing form. |