Energy Right Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3316-0019 can be found here:

Documents and Forms

Document Name Document Type
Form 17651 Energy Right Program Form
17651 New Homes WCF 17651_New Homes WCF 4 1 07.doc Form
17655 Agreement to Participate-Homeowner 17655_Agreement to Participate-Homeowner.doc Form
17652 Water Heater Work Completion Form 17652_WH WCF.doc Form
17654 Schedule P - Program Implementaion Plan 17654_Schedule P 4 1 07.doc Form
17656 Agreement to Participate-Landlord.doc 17656_Agreement to Participate-Landlord.doc Form
17657 Repayment Agreement 17657_Repayment Agreement.doc Form
17658 Security Agreement 17658_Security Agreement.doc Form
17659 Notice of Right to Cancel 17659_Notice of Right to Cancel.doc Form
17676 Manufactured Home Validation 17676.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Energy Right Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	17651	New Homes WCF	17651_New Homes WCF 4 1 07.doc	Yes	Yes	Fillable Fileable Signable
Form	17655	Agreement to Participate-Homeowner	17655_Agreement to Participate-Homeowner.doc	Yes	Yes	Fillable Fileable Signable
Form	17652	Water Heater Work Completion Form	17652_WH WCF.doc	Yes	Yes	Fillable Fileable Signable
Form	17654	Schedule P - Program Implementaion Plan	17654_Schedule P 4 1 07.doc	Yes	Yes	Fillable Fileable Signable
Form	17656	Agreement to Participate-Landlord.doc	17656_Agreement to Participate-Landlord.doc	Yes	Yes	Fillable Fileable Signable
Form	17657	Repayment Agreement	17657_Repayment Agreement.doc	Yes	Yes	Fillable Fileable Signable
Form	17658	Security Agreement	17658_Security Agreement.doc	Yes	Yes	Fillable Fileable Signable
Form	17659	Notice of Right to Cancel	17659_Notice of Right to Cancel.doc	Yes	Yes	Fillable Fileable Signable
Form	17676	Manufactured Home Validation	17676.pdf	Yes	Yes	Printable Only

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 29,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	29,000	-2,000	31,000
Annual IC Time Burden (Hours)	8,700	-600	9,300
Annual IC Cost Burden (Dollars)	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.