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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
5900-20
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 and Instruction
5900-21
Small Business Network Form
Small Business Network.doc
http://www.energystar.gov/index.cfm?c=small_business.sb_partner_info_form
Yes
Yes
Fillable Fileable
Form
5900-22
Statement of Energy Design Intent
Statement of Energy Design Intent.docx
http://www.energystar.gov/ia/business/tools_resources/target_finder/help/Statement_of_Energy_Design_Intent.htm
Yes
No
Fillable Printable
Form
5900-198
Statement of Energy Improvement
Statement of Energy Improvement.doc
www.energystar.gov
Yes
No
Fillable Printable
Form
5900-89
Statement of Energy Performance - Plants
Statement of Energy Performance - Plants.doc
www.energystar.gov
Yes
No
Fillable Printable
Form and Instruction
5900-195
SPP Partnership Agreement
SPP Partnership Agreement.docx
https://www.energystar.gov/index.cfm?fuseaction=opa.showPartnershipCategory&p_code=SP&newAgreement=true
Yes
Yes
Fillable Fileable
Form and Instruction
5900-33
EEPS Partnership Agreement
EEPS_Partnership_Agreement.docx
http://www.energystar.gov/ia/about/join/EEPS_Partnership_Agreement.pdf?0c90-dd4a
Yes
Yes
Fillable Fileable
Form
5900-19
C&I Partnership Letter
C&I Partnership_Letter.doc
https://www.energystar.gov/index.cfm?fuseaction=opa.showPartnershipApplicationChecklist&p_code=ESB&associations=false&newAgreement=true
Yes
Yes
Fillable Fileable
Form and Instruction
5900-263
Challenge for Industry Registration Form
ENERGY STAR - Challenge for Industry Registration Form.docx
https://docs.google.com
Yes
Yes
Fillable Fileable
Form and Instruction
5900-262
Challenge for Industry Online Recognition Application
ENERGY STAR - Challenge for Industry Recognition Application.docx
https://docs.google.com
Yes
Yes
Fillable Fileable
Form
5900-265
EPI Award Specification Sheet
Plant Award Specification Sheet.doc
www.energystar.gov
Yes
No
Fillable Printable
Form and Instruction
5900-264
EPI Award Application Letter
Plant Award Application Letter.doc
www.energystar.gov
Yes
No
Fillable Printable
Form
5900-197
Data Checklist
Data Checklist.pdf
www.energystar.gov
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:
10,366
Number of Respondents for Small Entity:
1,650
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions, Farms
Percentage of Respondents Reporting Electronically:
99 %
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
135,072
0
117
105,736
0
29,219
Annual IC Time Burden (Hours)
121,542
0
48
43,447
0
78,047
Annual IC Cost Burden (Dollars)
7,748,080
0
11,900
3,254,236
0
4,481,944
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.