View Information Collection (IC)

View Information Collection (IC)

IC Title:	Energy Star Program in the Residential Sector: Households	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	5900-184	Homeowner Energy Data Release Form	EnergyUseReleaseForm.DOC	energystar.gov	Yes	No	Printable Only
Form and Instruction	5900-179	Home Improvement Profile Form	ENERGY STAR HIP Profile 05 04 09.doc	energystar.gov	Yes	No	Printable Only
Form and Instruction	5900-182	Home Performance Homeowner Satisfaction Form	HPwESCust_Sat_Form.doc	energystar.gov	Yes	No	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 52,010	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	52,010	0	52,010	0	0	0
Annual IC Time Burden (Hours)	15,600	0	15,600	0	0	0
Annual IC Cost Burden (Dollars)	440	0	440	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.