Information Collection

Energy Star Program in the Residential Sector: Private Sector

IC 44052 under ICR 200910-2060-009 · OMB 2060-0586.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2060-0586 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5900-172 Energy Star Program in the Residential Sector: Private Sector	Form and Instruction
5900-172 Site Installation Checklist for Energy Star Manufactured Site Installation Checklist - Template.doc	Form and Instruction
5900-189 Completion Report for Energy Star Modular Home Completion Report ENERGY STAR Modular Home (APR 09).doc	Form and Instruction
5900-192 Performance Path Inspection Checklist for Energy Star Mo Inspection Checklist ENERGY STAR Modular Home - Performance.doc	Form and Instruction
5900-193 Modular Home Certifier Applicaton Modular Certifier Application.doc	Form and Instruction
5900-194 Qualification to Produce Energy Star Modular Homes Qualification to Produce ENERGY STAR Modular Homes (JUL 09).doc	Form and Instruction
5900-190 Inspection Checklist Energy Star Modular Home (Prescrpti Inspection Checklist ENERGY STAR Modular Home - Prescriptive.doc	Form and Instruction
5900-191 Modular Home Rater Applicaton Modular Rater Application.doc	Form and Instruction
5900-180 HVAC QI Commission Report ESQI_commissionreport_draft080509.xls energystar.gov	Form and Instruction
5900-181 HP w/ ES Sponsor Reporting Form HPwES Reporting Template 06-14- 07.xls energystar.gov	Form
5900-187 HPw/ES Test Out Form Test-out Form.xls energystar.gov	Form
5900-186 HPw/ES Program Plan Template Home Performance Program Plan Template.doc energystar.gov	Form and Instruction
5900-183 HVAC QI Partnership Agreement ENERGY STAR HVAC QI Partnership Agreement.doc energystar.gov	Form and Instruction
5900-173 IAQ Checklist IAQ Checklist.doc energystar.gov/homes	Form
5900-176 Thermal Bypass Checklist for Energy Star Homes Energy Star Home Thermal Bypass Checklist.doc energystar.gov/homes	Form
5900-177 Quality Framing Checklist for Energy Star Homes ES Quality Framing Checklist.doc energystar.gov/homes	Form
5900-175 HVAC QI Checklist for Contractors HVAC QI Contractor Checklist.doc energystar.gov	Form
5900-174 HVAC QI Checklist for Verifiers HVAC QI Verifier Checklist.doc energystar.gov	Form
5900-178 Water Managed Construction Checklist for Energy Star Hom Water Managed Construction Checklist.doc energystar.gov	Form
5900-185 Home Performance Partnership Agreement for Contractors HPwES Pilot Contractor PA-07-20-09.doc energystar.gov	Form
5900-188 Energy Star Partnership Agreement for Architects/Designe Energy Star Architect Partnership Agreement.ppt energystar.gov/homes	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Energy Star Program in the Residential Sector: Private Sector

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	5900-172	Site Installation Checklist for Energy Star Manufactured Homes	Site Installation Checklist - Template.doc		Yes	No	Printable Only
Form and Instruction	5900-189	Completion Report for Energy Star Modular Home	Completion Report ENERGY STAR Modular Home (APR 09).doc		Yes	No	Printable Only
Form and Instruction	5900-192	Performance Path Inspection Checklist for Energy Star Modular Home	Inspection Checklist ENERGY STAR Modular Home - Performance.doc		Yes	No	Printable Only
Form and Instruction	5900-193	Modular Home Certifier Applicaton	Modular Certifier Application.doc		Yes	No	Printable Only
Form and Instruction	5900-194	Qualification to Produce Energy Star Modular Homes	Qualification to Produce ENERGY STAR Modular Homes (JUL 09).doc		Yes	No	Printable Only
Form and Instruction	5900-190	Inspection Checklist Energy Star Modular Home (Prescrptive)	Inspection Checklist ENERGY STAR Modular Home - Prescriptive.doc		Yes	No	Printable Only
Form and Instruction	5900-191	Modular Home Rater Applicaton	Modular Rater Application.doc		Yes	No	Printable Only
Form and Instruction	5900-180	HVAC QI Commission Report	ESQI_commissionreport_draft080509.xls	energystar.gov	Yes	No	Printable Only
Form	5900-181	HP w/ ES Sponsor Reporting Form	HPwES Reporting Template 06-14- 07.xls	energystar.gov	Yes	No	Printable Only
Form	5900-187	HPw/ES Test Out Form	Test-out Form.xls	energystar.gov	Yes	No	Printable Only
Form and Instruction	5900-186	HPw/ES Program Plan Template	Home Performance Program Plan Template.doc	energystar.gov	Yes	No	Printable Only
Form and Instruction	5900-183	HVAC QI Partnership Agreement	ENERGY STAR HVAC QI Partnership Agreement.doc	energystar.gov	Yes	No	Printable Only
Form	5900-173	IAQ Checklist	IAQ Checklist.doc	energystar.gov/homes	Yes	No	Fillable Printable
Form	5900-176	Thermal Bypass Checklist for Energy Star Homes	Energy Star Home Thermal Bypass Checklist.doc	energystar.gov/homes	Yes	No	Fillable Printable
Form	5900-177	Quality Framing Checklist for Energy Star Homes	ES Quality Framing Checklist.doc	energystar.gov/homes	Yes	No	Fillable Printable
Form	5900-178	Water Managed Construction Checklist for Energy Star Homes	Water Managed Construction Checklist.doc	energystar.gov	Yes	No	Fillable Printable
Form	5900-175	HVAC QI Checklist for Contractors	HVAC QI Contractor Checklist.doc	energystar.gov	Yes	No	Fillable Printable
Form	5900-174	HVAC QI Checklist for Verifiers	HVAC QI Verifier Checklist.doc	energystar.gov	Yes	No	Fillable Printable
Form	5900-185	Home Performance Partnership Agreement for Contractors	HPwES Pilot Contractor PA-07-20-09.doc	energystar.gov	Yes	No	Fillable Printable
Form and Instruction	5900-188	Energy Star Partnership Agreement for Architects/Designers	Energy Star Architect Partnership Agreement.ppt	energystar.gov/homes	Yes	Yes	Fillable Fileable Signable

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: 4,181

Number of Respondents for Small Entity: 3,000

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	89,317	-8,534	-12,996	110,847
Annual IC Time Burden (Hours)	161,784	6,905	-20,570	175,449
Annual IC Cost Burden (Dollars)	16,849	8,993	-120,144	128,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.