Information Collection

ENERGY STAR Program in the Commercial and Industrial Sectors - Private Sector Entities

IC 24482 under ICR 201001-2060-002 · OMB 2060-0347.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2060-0347 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5900-20 ENERGY STAR Program in the Commercial and Industrial Sectors - Private Sector Entities	Form
5900-195 Service and Product Provider (SPP) Partnership Applicati SPP_Application_Data_Form.doc www.energystar.gov/ia/about/join/Application_Data_Form.doc	Form
5900-196 Take the ENERGY STAR Challenge! ENERGY STAR Challenge Form.doc www.energystar.gov/index.cfm?fuseaction=challenge.showChallengeForm	Form
5900-197 ENERGY STAR Data Checklist for Commercial Buildings ENERGY STAR Data_Checklist_09.pdf www.energystar.gov/ia/business/evaluate_performance/Data_Checklist_09.pdf	Form
5900-21 Small Business and Congregations Network Small Business and Congregations Network.doc www.energystar.gov/index.cfm?c=small_business.sb_partner_info_form	Form
5900-19 Attachment to Partnership Letter Partnership_Letter.doc www.energystar.gov/ia/business/partnerletter.pdf	Form
5900-198 Statement of Energy Improvement Statement of Energy Improvement.doc www.energystar.gov	Form
5900-22 Statement of Energy Design Intent Statement of Energy Design Intent.pdf www.energystar.gov/ia/business/tools_resources/new_bldg_design/SEDI_Example.pdf	Form
5900-20 ENERGY STAR Leaders - Facility Summary Report Leaders Facility Summary Report.doc www.energystar.gov/istar/pmpam	Form
5900-20 ENERGY STAR Leaders - Leaders Story Leaders Story.doc www.energystar.gov/istar/pmpam	Form
5900-20 ENERGY STAR Leaders - Eligible Facilities List Leaders Eligible Facilities.doc www.energystar.gov/istar/pmpam	Form
5900-20 ENERGY STAR Leaders - Ineligible Facilities List Leaders Ineligible Facilities.doc www.energystar.gov/istar/pmpam	Form
5900-89 Statement of Energy Performance Statement of Energy Performance - Plants.doc www.energystar.gov/index.cfm?c=in_focus.bus_cement_manuf_focus	Form
5900-16 Statement of Energy Performance Statement of Energy Performance - Buildings.pdf www.energystar.gov/ia/business/evaluate_performance/SEP_08.pdf	Form

Information Collection (IC) Details

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
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
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

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 %

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	29,219	-1,067	16,069	14,217
Annual IC Time Burden (Hours)	78,047	-3,065	46,127	34,985
Annual IC Cost Burden (Dollars)	4,481,944	-268	3,073,643	1,408,569

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.