View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Home Energy Score (HEScore)	Agency IC Tracking Number:	Chris Early

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 and Instruction	DOE F 413.26	Partnership Agreement	DOE HQ F 413.26-Partnership Agreement.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 413.24	Partner Implementation Plan Template	DOE HQ F 413.24- Home Energy Score Partner Implementation Plan Templateomb.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 413.40	Remote Service Provider Implementation Template	DOE HQ F 413.40- Home Energy Score Remote Service Provider Implementation Plan omb.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 413.27	Assessor Candidate Enrollment	DOE HQ F 413.27 -Access Candidate Enrollment Form.pdf		Yes	Yes	Fillable Fileable
Form	DOE F 413.25	Tool Data Collection Form	DOE HQ F 413.25- Home Energy Scoring Tool.pdf		Yes	Yes	Fillable Fileable
Instruction			Instructions for DOE HQ F 413.25.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 414.39	HIE Partner Agreement	DOE HQ F 413.39- HIE Partner Agreement MTV Final Clean.docx		Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 413.41	HIE Partner Quarterly Reporting Form	DOE HQ F 413.41 HIE Partner Quarterly Reporting Form.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Energy

Subfunction: Energy Conservation and Preparedness

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 390	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	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	34,407	0	-48,000	0	82,407	0
Annual IC Time Burden (Hours)	13,536	0	6,818	0	6,718	0
Annual IC Cost Burden (Dollars)	3,035,491	0	1,106,042	0	1,929,449	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.