Party: __________________ Reporting year: __________________

Before beginning the questionnaire, respondents are requested to read the following sections of the data reporting instructions and guidelines document carefully: (a) Section 1: Introduction; (b) Section 3: General instructions; and (c) Section 4: Definitions. Respondents are encouraged to refer to the data reporting instructions and guidelines as necessary when completing the data forms.

Questionnaire

1.1. Did your country import CFCs, halons, carbon tetrachloride, methyl chloroform, HCFCs, HBFCs, bromochloromethane, methyl bromide or HFCs in the reporting year?

Yes [ ] No [ ]

If No, ignore data form 1 and go to question 1.2. If Yes, please complete data form 1. Please read instruction I (on data on imports of controlled substances) of the data reporting instructions and guidelines document carefully before filling in the form.

1.2. Did your country export or re‑export CFCs, halons, carbon tetrachloride, methyl chloroform, HCFCs, HBFCs, bromochloromethane, methyl bromide or HFCs in the reporting year?

Yes [ ] No [ ]

If No, ignore data form 2 and go to question 1.3. If Yes, please complete data form 2. Please read instruction II (on data on exports of controlled substances) of the data reporting instructions and guidelines document carefully before filling in the form.

1.3. Did your country produce CFCs, halons, carbon tetrachloride, methyl chloroform, HCFCs, HBFCs, bromochloromethane, methyl bromide or HFCs in the reporting year?

Yes [ ] No [ ]

If No, ignore data form 3 and go to question 1.4. If Yes, please complete data form 3. Please read instruction III (on data on production of controlled substances) of the data reporting instructions and guidelines document carefully before filling in the form.

1.4. Did your country destroy any ozone-depleting substances or HFCs in the reporting year?

Yes [ ] No [ ]

If No, ignore data form 4 and go to question 1.5. If Yes, please complete data form 4. Please read instruction IV (on data on destruction of controlled substances) of the data reporting instructions and guidelines document carefully before filling in the form.

1.5. Did your country import from or export or re‑export to non‑parties in the reporting year?

Yes [ ] No [ ]

If No, ignore data form 5 and go to question 1.6. If Yes, please complete data form 5. Please read instruction V (on data on imports from and exports to non-parties) of the data reporting instructions and guidelines document carefully, particularly the definition of non‑parties, before filling in the form.

1.6. Did your country generate the substance HFC‑23 in the reporting year from any facility that produces (manufactures) Annex C Group I or Annex F substances?

Yes [ ] No [ ]

If No, ignore data form 6. If Yes, please complete data form 6. Please read instruction VI (on data on emissions of Annex F Group II substance – HFC-23) of the data reporting instructions and guidelines document carefully before filling in the form.

Name of reporting officer:....................................................................................................................................................

Signature:............................................................................................................................................................................

Designation:........................................................................................................................................................................

Organization:.......................................................................................................................................................................

Postal address:.....................................................................................................................................................................

Country:..............................................................................................................................................................................

Phone:.................................................................................................................................................................................

Email:..................................................................................................................................................................................

Date:...................................................................................................................................................................................

1. Fill in this form only if your country imported

DATA FORM 1

A7_Dataform/2018

 CFCs, halons, carbon tetrachloride, methyl chloroform, HCFCs,

 HBFCs, bromochloromethane, methyl bromide or HFCs

DATA ON IMPORTS

2. Please read instruction I carefully

in tonnes^[1] (not ODP or CO₂-equivalent tonnes)

 before filling in this form.

Annex A, B, C, E and F substances

Party: _________________________

Period: January – December 20____

A‑Group I

CFC‑11 (CFCl₃)

CFC‑12 (CF₂Cl₂)

CFC‑113 (C₂F₃Cl₃)

CFC‑114 (C₂F₄Cl₂)

CFC‑115 (C₂F₅Cl)

A‑Group II

Halon-1211 (CF₂BrCl)

Halon-1301 (CF₃Br)

Halon-2402 (C₂F₄Br₂)

B‑Group I

CFC‑13 (CF₃Cl)

B‑Group II

Carbon tetrachloride (CCl₄)

B‑Group III 

Methyl chloroform, i.e., 1,1,1‑trichloroethane (C₂H₃Cl₃)

Comments:

^[1] Tonne = Metric ton.

* Against each substance imported for exempted essential, critical or other uses, please specify the meeting of the parties decision that approved the use. Should the column space be insufficient, further information can be provided in the “comments” box above.

C‑Group I

HCFC‑21** (CHFCl₂)

HCFC‑22** (CHF₂Cl)

HCFC‑31 (CH₂FCl)

HCFC‑123** (CHCl₂CF₃)

HCFC‑124** (CHFClCF₃)

HCFC‑133 (C₂H₂F₃Cl)

HCFC‑141b** (CH₃CFCl₂)

HCFC‑142b** (CH₃CF₂Cl)

HCFC‑225 (C₃HF₅Cl₂)

HCFC‑225ca (CF₃CF₂CHCl₂)

HCFC‑225cb (CF₂ClCF₂CHClF)

C‑Group II

HBFCs

C‑Group III

Bromochloromethane (CH₂BrCl)

E‑Group I

Methyl bromide (CH₃Br)

Quantity of new methyl bromide imported to be used for quarantine and pre‑shipment applications within your country

Comments:

Note: As per paragraph 5 bis of Article 2 of the Protocol, any transfer of HCFC consumption by parties not operating under paragraph 1 of Article 5 shall be notified to the Secretariat, no later than the time of the transfer, by each of the parties concerned, stating the terms of such transfer and the period for which it is to apply.

* Against each substance imported for exempted essential, critical or other uses, please specify the meeting of the parties decision that approved the use. Should the column space be insufficient, further information can be provided in the “comments” box above.

** Identifies the most commercially viable substances with ozone-depleting-potential (ODP) values listed against them to be used for the purposes of the Protocol.

F‑Group I

HFC‑32 (CH₂F₂)

HFC‑41 (CH₃F)

HFC‑125 (CHF₂CF₃)

HFC‑134 (CHF₂CHF₂)

HFC‑134a (CH₂FCF₃)

HFC‑143 (CH₂FCHF₂)

HFC‑143a (CH₃CF₃)

HFC‑152 (CH₂FCH₂F)

HFC‑152a (CH₃CHF₂)

HFC‑227ea (CF₃CHFCF₃)

HFC‑236cb (CH₂FCF₂CF₃)

HFC‑236ea (CHF₂CHFCF₃)

HFC‑236fa (CF₃CH₂CF₃)

HFC‑245ca (CH₂FCF₂CHF₂)

HFC‑245fa (CHF₂CH₂CF₃)

HFC‑365mfc (CF₃CH₂CF₂CH₃)

HFC‑43‑10mee (CF₃CHFCHFCF₂CF₃)

F‑Group II

HFC‑23 (CHF3)

Mixtures containing controlled substance(s) – applicable to all substances, not just HFCs (add additional rows or pages as required for mixtures not listed below)

R‑404A (HFC-125 = 44%, HFC-134a = 4%, HFC-143a = 52%)

R‑407A (HFC-32 = 20%, HFC-125 = 40%, HFC-134a = 40%)

R‑407C (HFC-32 = 23%, HFC-125 = 25%, HFC-134a = 52%)

R‑410A (HFC-32 = 50%, HFC-125 = 50%)

R-507A (HFC-125 = 50%, HFC-143a = 50%)

R‑508B (HFC-23 = 46%, PFC-116 = 54%)

Comments:

Note: When reporting mixtures, reporting of controlled substances should not be duplicated. Parties may choose to report imports of individual controlled substances, total quantities of mixtures imported, or a combination of both, provided that the amounts of imported controlled substances are not reported more than once. If a non‑standard mixture not listed in section 11 of the data reporting instructions and guidelines is to be reported, please indicate the percentage by weight of each constituent controlled substance of the mixture being reported in the “remark” column or in the “comments” box above.

* Against each substance imported for exempted essential, critical, high-ambient-temperature or other uses, please specify the meeting of the parties decision that approved the use. Should the column space be insufficient, further information can be provided in the “comments” box above. In case of multiple exemptions per substance for some of the controlled substances, multiple entries may be used for those substances to report on those exemptions.

Annex to DATA FORM 1 ‑ Exporting parties for quantities reported as imports

A7_Dataform/2018

Note: This annex is excluded from the reporting requirements under Article 7 of the Protocol, and the information in the annex is to be provided on a voluntary basis (decision XXIV/12)

(1)

Substance or Mixture 

(2)

Exporting party for quantities reported as imports  

Total quantity imported for all uses

(5)

Quantity of new substance imported for feedstock uses

Quantity of new substance imported for exempted essential, critical, high-ambient-temperature or other uses*

(3)

New

(4)

Recovered and reclaimed

(6)

Quantity

(7)

Decision / type of use* or remarks

Methyl bromide (CH₃Br)

Quantity of new methyl bromide imported to be used for quarantine and pre‑shipment applications within your country

Comments:

* Against each substance imported for exempted essential, critical, high-ambient-temperature or other uses, please specify the meeting of the parties decision that approved the use. Should the column space be insufficient, further information can be provided in the “comments” box above.

1. Fill in this form only if your country exported or re‑exported

DATA FORM 2

A7_Dataform/2018

 CFCs, halons, carbon tetrachloride, methyl chloroform, HCFCs,

 HBFCs, bromochloromethane, methyl bromide or HFCs

DATA ON EXPORTS*

2. Please read instruction II carefully

in tonnes^[1] (not ODP or CO₂-equivalent tonnes)

 before filling in this form.

Annex A, B, C, E and F substances

Party: ____________________

Period: January – December 20____

(1)

Substance or Mixture

(2)

Country of destination of exports**

Total quantity exported for all uses

(5)

Quantity of new substance exported for feedstock uses***

Quantity of new substance exported for exempted essential, critical, high-ambient-temperature or other uses****

(3)

New

(4)

Recovered and reclaimed

(6)

Quantity

(7)

Decision / type of use**** or remarks

Methyl bromide (CH₃Br)

Quantity of new methyl bromide exported to be used for quarantine and pre‑shipment applications 

Comments:

^[1] Tonne = Metric ton.

Note: If a non‑standard mixture not listed in section 11 of the data reporting instructions and guidelines is to be reported, please indicate the percentage by weight of each constituent controlled substance of the mixture being reported in the “remark” column or in the “comments” box above.

* Includes re‑exports. Ref. decisions IV/14 and XVII/16, paragraph 4.

** Reporting of countries of destination is not a requirement under Article 7. In paragraph 4 of decision VII/9, it was decided that parties should report on the destination of Annex A and Annex B substances (new, recovered or reclaimed) that are exported. Paragraph 4 of decision XVII/16 requested a revision of the reporting formats to cover the export of all controlled substances contained in the annexes of the Protocol, and urged the Parties to implement the revised reporting format expeditiously.

*** Do not deduct from total production in column 3 of data form 3 (data on production).

**** Against each substance exported for exempted essential, critical, high-ambient-temperature or other uses, please specify the meeting of the parties decision that approved the use. Should the column space be insufficient, further information can be provided in the “comments” box above.

1. Fill in this form only if your country produced

DATA FORM 3

A7_Dataform/2018

 CFCs, halons, carbon tetrachloride, methyl chloroform, HCFCs,

 HBFCs, bromochloromethane, methyl bromide or HFCs

DATA ON PRODUCTION AND HFC-23 GENERATION

 or generated HFC-23

2. Please read instruction III carefully before

in tonnes^[1] (not ODP or CO₂-equivalent tonnes)

 filling in this form

Annex A, B, C, E and F substances

Party: __________________

Period: January – December 20____

A‑Group I

CFC‑11 (CFCl₃)

This column is no longer applicable to Annex A and B substances (CFCs, halons, CCl₄ and methyl chloroform)

CFC‑12 (CF₂Cl₂)

CFC‑113 (C₂F₃Cl₃)

CFC‑114 (C₂F₄Cl₂)

CFC‑115 (C₂F₅Cl)

A‑Group II

Halon-1211 (CF₂BrCl)

Halon-1301 (CF₃Br)

Halon-2402 (C₂F₄Br₂)

B‑Group I

CFC‑13 (CF₃Cl)

B‑Group II

Carbon tetrachloride (CCl₄)

B‑Group III

Methyl chloroform, i.e., 1,1,1‑trichloroethane (C₂H₃Cl₃)

Comments:

^[1] Tonne = Metric ton.

Note: As per paragraph 5 of Article 2 of the Protocol, any transfer of production shall be notified to the Secretariat, no later than the time of the transfer, by each of the parties concerned, stating the terms of such transfer and the period for which it is to apply.

* Against each substance produced for exempted essential, critical or other uses, please specify the meeting of the parties decision that approved the use. Should the column space be insufficient, further information can be provided in the “comments” box above.

C‑Group I

HCFC‑21** (CHFCl₂)

HCFC‑22** (CHF₂Cl)

HCFC‑31 (CH₂FCl)

HCFC‑123** (CHCl₂CF₃)

HCFC‑124** (CHFClCF₃)

HCFC‑133 (C₂H₂F₃Cl)

HCFC‑141b** (CH₃CFCl₂)

HCFC‑142b** (CH₃CF₂Cl)

HCFC‑225 (C₃HF₅Cl₂)

HCFC‑225ca (CF₃CF₂CHCl₂)

HCFC‑225cb (CF₂ClCF₂CHClF)

C‑Group II

HBFCs

This column is no longer applicable to Annex/group C/II, C/III and E/I substances (HBFCs, BCM and methyl bromide)

C‑Group III

Bromochloromethane (CH₂BrCl)

E‑Group I

Methyl bromide (CH₃Br)

Total quantity of new methyl bromide produced for quarantine and pre‑shipment applications within your country and for export

Comments:

Note: As per paragraph 5 of Article 2 of the Protocol, any transfer of production shall be notified to the Secretariat, no later than the time of the transfer, by each of the parties concerned, stating the terms of such transfer and the period for which it is to apply.

* Against each substance produced for exempted essential, critical or other uses, please specify the meeting of the parties decision that approved the use. Should the column space be insufficient, further information can be provided in the “comments” box above.

** Identifies the most commercially viable substances with ozone-depleting-potential (ODP) values listed against them to be used for the purposes of the Protocol.

F‑Group I

HFC‑32 (CH₂F₂)

This column is not applicable to Annex F substances (HFCs)

HFC‑41 (CH₃F)

HFC‑125 (CHF₂CF₃)

HFC‑134 (CHF₂CHF₂)

HFC‑134a (CH₂FCF₃)

HFC‑143 (CH₂FCHF₂)

HFC‑143a (CH₃CF₃)

HFC‑152 (CH₂FCH₂F)

HFC‑152a (CH₃CHF₂)

HFC‑227ea (CF₃CHFCF₃)

HFC‑236cb (CH₂FCF₂CF₃)

HFC‑236ea (CHF₂CHFCF₃)

HFC‑236fa (CF₃CH₂CF₃)

HFC‑245ca (CH₂FCF₂CHF₂)

HFC‑245fa (CHF₂CH₂CF₃)

HFC‑365mfc (CF₃CH₂CF₂CH₃)

HFC‑43‑10mee (CF₃CHFCHFCF₂CF₃)

(3)

Captured for all uses**

(4a)

Captured for feedstock uses within your country***

(4b)

Captured for destruction***

F‑Group II

HFC‑23 (CHF₃)**

Comments:

Note: As per paragraph 5 of Article 2 of the Protocol, any transfer of production shall be notified to the Secretariat, no later than the time of the transfer, by each of the parties concerned, stating the terms of such transfer and the period for which it is to apply.

* Against each substance produced for exempted essential, critical, high-ambient-temperature or other uses, please specify the meeting of the parties decision that approved the use. Should the column space be insufficient, further information can be provided in the “comments” box above.

** HFC-23 generation that is captured, whether for destruction, feedstock or any other use, shall be reported in this form.

***Amounts of HFC-23 captured for destruction or feedstock use will not be counted as production as per Article 1.

1. Fill in this form only if your country destroyed

DATA FORM 4

A7_Dataform/2018

 CFCs, halons, carbon tetrachloride, methyl chloroform, HCFCs,

 HBFCs, bromochloromethane, methyl bromide or HFCs

DATA ON QUANTITY OF SUBSTANCES DESTROYED

2. Please read instruction IV carefully

in tonnes^[1] (not ODP or CO₂-equivalent tonnes)

 before filling in this form

Annex A, B, C, E and F substances

 Party: ___________________

Period: January – December 20____

(1)
Substance or Mixture

(2)
Quantity destroyed

(3)
Remarks

Comments:

^[1] Tonne = Metric ton.

Note: If the composition of a destroyed mixture is known, please indicate the percentage by weight of each constituent controlled substance of the mixture being reported in the remarks or comments section of the form or indicate a standard mixture as listed in section 11 of the data reporting instructions and guidelines.

1. Fill in this form only if your country imported or exported

DATA FORM 5

A7_Dataform/2018

 CFCs, halons, carbon tetrachloride, methyl chloroform, HCFCs,

 HBFCs, bromochloromethane or methyl bromide from or

DATA ON IMPORTS FROM AND/OR EXPORTS TO NON‑PARTIES*

 to non‑parties

in tonnes^[1] (not ODP or CO₂-equivalent tonnes)

2. Please read instruction V carefully

 before filling in this form.

Annex A, B, C and E substances

Party: __________________

Period: January – December 20____

(1)

Substance or Mixture

(2)

Exporting party for quantities reported as imports 
OR
Country of destination of exports**

Quantity of imports from non-parties*

Quantity of exports to non-parties*

(7)
Remarks

(3)

New imports 

(4)

Recovered and reclaimed imports

(5)

New exports

(6)
Recovered and reclaimed exports

Comments:

^[1] Tonne = Metric ton.

Note: If a non‑standard mixture not listed in section 11 of the data reporting instructions and guidelines is to be reported, please indicate the percentage by weight of each constituent controlled substance of the mixture being reported in the “remark” column or in the “comments” box above.

* See definition of “non‑parties” in Instruction V.

** Reporting of information on “exporting parties for quantities reported as imports” and “countries of destination of exports” is not a requirement under Article 7 of the Protocol, and the information is to be provided on a voluntary basis.

1. Fill in this form only if your country generated HFC‑23 from any facility that produced (manufactured) Annex C Group I or Annex F substances

2. Please read instruction VI carefully before filling in this form

Party: ___________________

DATA FORM 6

DATA ON QUANTITY OF EMISSIONS OF HFC 23 FROM

FACILITIES MANUFACTURING ANNEX C GROUP I OR ANNEX F SUBSTANCES

in tonnes[1] (not ODP or CO2-equivalent tonnes)

Period: January – December 20____

A7_Dataform/2018

Note: Information in columns 2 to 5 is excluded from the reporting requirements under Article 7 of the Protocol and is provided on a voluntary basis.

(1)

Facility name or identifier

(2)

Total amount
generated*
(tonnes)

(3)

Amount
generated and captured**
(tonnes)

(4)

Amount used for feedstock without prior capture***
(tonnes)

(5)

Amount destroyed without prior capture ****
(tonnes)

(6)

Amount of generated emissions
(tonnes)

(7)

Remarks

(3a)

For all uses

(3b)

For feedstock use in your country

(3c)
For destruction

Comments:

[1] Tonne = Metric ton.

* “Total amount generated” refers to the total amount whether captured or not. The sum of these amounts is not to be reported under data form 3.

** The sums of these amounts are to be reported under data form 3.

*** Amount converted to other substances in the facility. The sum of these amounts is not to be reported under data form 3.

**** Amount destroyed in the facility.