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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
ENERGY STAR Program in the Commercial and Industrial Sectors - Private Sector Entities
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
5900-195
Service and Product Provider (SPP) Partnership Application Data Form
SPP_Application_Data_Form.doc
http://www.energystar.gov/ia/about/join/Application_Data_Form.doc
Yes
Yes
Fillable Fileable
Form
5900-196
Take the ENERGY STAR Challenge!
ENERGY STAR Challenge Form.doc
http://www.energystar.gov/index.cfm?fuseaction=challenge.showChallengeForm
Yes
Yes
Fillable Fileable
Form
5900-197
ENERGY STAR Data Checklist for Commercial Buildings
ENERGY STAR Data_Checklist_09.pdf
http://www.energystar.gov/ia/business/evaluate_performance/Data_Checklist_09.pdf
Yes
Yes
Fillable Printable
Form
5900-21
Small Business and Congregations Network
Small Business and Congregations Network.doc
http://www.energystar.gov/index.cfm?c=small_business.sb_partner_info_form
Yes
Yes
Fillable Fileable
Form
5900-19
Attachment to Partnership Letter
Partnership_Letter.doc
http://www.energystar.gov/ia/business/partnerletter.pdf
Yes
Yes
Fillable Printable
Form
5900-198
Statement of Energy Improvement
Statement of Energy Improvement.doc
www.energystar.gov
Yes
Yes
Fillable Printable
Form
5900-22
Statement of Energy Design Intent
Statement of Energy Design Intent.pdf
http://www.energystar.gov/ia/business/tools_resources/new_bldg_design/SEDI_Example.pdf
Yes
Yes
Fillable Printable
Form
5900-20
ENERGY STAR Leaders - Facility Summary Report
Leaders Facility Summary Report.doc
https://www.energystar.gov/istar/pmpam
Yes
Yes
Fillable Printable
Form
5900-20
ENERGY STAR Leaders - Leaders Story
Leaders Story.doc
https://www.energystar.gov/istar/pmpam
Yes
Yes
Fillable Printable
Form
5900-20
ENERGY STAR Leaders - Eligible Facilities List
Leaders Eligible Facilities.doc
https://www.energystar.gov/istar/pmpam
Yes
Yes
Fillable Printable
Form
5900-20
ENERGY STAR Leaders - Ineligible Facilities List
Leaders Ineligible Facilities.doc
https://www.energystar.gov/istar/pmpam
Yes
Yes
Fillable Printable
Form
5900-89
Statement of Energy Performance
Statement of Energy Performance - Plants.doc
http://www.energystar.gov/index.cfm?c=in_focus.bus_cement_manuf_focus
Yes
Yes
Fillable Printable
Form
5900-16
Statement of Energy Performance
Statement of Energy Performance - Buildings.pdf
http://www.energystar.gov/ia/business/evaluate_performance/SEP_08.pdf
Yes
Yes
Fillable Printable
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:
11,471
Number of Respondents for Small Entity:
2,500
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions, Farms
Percentage of Respondents Reporting Electronically:
95 %
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
29,219
0
-1,067
16,069
0
14,217
Annual IC Time Burden (Hours)
78,047
0
-3,065
46,127
0
34,985
Annual IC Cost Burden (Dollars)
4,481,944
0
-268
3,073,643
0
1,408,569
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.