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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:...................................................................................................................................................................................
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