Information Collection

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

IC 45386 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⚠️ Notice: This information collection may be referencing outdated material.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 5900-196 ENERGY STAR Program in the Commercial and Industrial Sectors - Public Sector Entities	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
5900-19 Attachment to Partnership Letter Partnership_Letter.doc www.energystar.gov/ia/business/partnerletter.pdf	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
5900-16 Statement of Energy Performance Statement of Energy Performance - Buildings.pdf www.energystar.gov/ia/business/evaluate_performance/SEP_08.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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

ENERGY STAR Program in the Commercial and Industrial Sectors - Public 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	5900-196	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	5900-19	Attachment to Partnership Letter	Partnership_Letter.doc	http://www.energystar.gov/ia/business/partnerletter.pdf	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
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	5900-16	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	5900-21	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

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: 6,247

Number of Respondents for Small Entity: 150

Affected Public: State, Local, and Tribal Governments

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	17,059	0	10,336	6,723
Annual IC Time Burden (Hours)	46,976	0	27,461	19,515
Annual IC Cost Burden (Dollars)	1,483,320	-229	1,029,900	453,649

Documents for IC

table that charts IC Documents
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.