5900-210 Qualified Product Information Form for Audio/Video Produ

United States ENVIRONMENTAL PROTECTION AGENCY

Washington, DC 20460

Version 2.0 Qualified Product Information Form for Audio/Video Products Office of Atmospheric Programs

ENERGY STAR® qualified product information form for use by ENERGY STAR qualified audio/video partners (Companies who have joined ENERGY STAR for audio/video by signing the Partnership Agreement). You may use this form to report only those products that are sold under your company’s brand name. If your firm sells its models to another company that uses its own brand name, that company must join the program and report its own products.

Under Tier 1 of the Version 2.0 specification, this form should be used to submit products that do not meet the Consumer AV Product definition. Products that meet the Consumer AV Product definition should be submitted through the Online Product Submittal tool. Under Tier 2 of the Version 2.0 specification, all products must be submitted using this form (https://www.energystar.gov/index.cfm?fuseaction=ops). Please complete this form using Microsoft Office Excel to ensure valid data. Information from this form will be added to the list of ENERGY STAR qualified Audio/Video products.

Please send this form for each qualifying product model or family to ENERGY STAR for Audio/Video via fax at (202) 862-1144 or email at [email protected].

Company Information

Company name

(as listed in Partnership Agreement):

Is your organization the OEM?

If not, who is?

Product contact information (for public requesting product information)

Name:

Title:

Tel:

Fax:

E-mail:

Product information submitted by (leave blank if same as product contact)

Name:

Title:

Tel:

Fax:

E-mail:

Basic Product Information

Please complete all the fields below unless otherwise noted (see Term Definitions at the end of the document).

Brand name/manufacturer:

If other brand name, please specify:

Model number:

Model name:

Initial date of manufacture:

Date no longer manufactured:

Date available on the market:

If date available is unknown, is this product currently available?

Manufacturer suggested retail price:

To what major markets is this product sold (check all that apply)?

Australia/New Zealand

Canada

China

European Union

Japan

Taiwan

USA

Does this product consist of several components with separate enclosures and power supplies?

If so, please list all components of the system:

Product Details

Product Type:

Product Description:

Does the device meet the criteria to be classified as a "Dedicated Audio DSP Device"?

Product functions (check all that apply)

Audio amplification (if checked, please fill out the section below on amplification)

Input Power:

watts (at 1/8 MUP

1 kHz Sine Wave)

Amplifier Class (please check all that apply):

A

B

AB

D

Other

Full-Spectrum Amplifier

Number of amplifiers:

Limited-Bandwidth Amplifier

Number of amplifiers:

Number of amplifier channels:

If other, please explain:

"Over the Air" (OTA) AM/FM Tuner

High resolution display

If checked, please indicate:

Resolution:

horizontal pixels

x

vertical pixels

Area:

square inches

Power Allowance:

watts

Networking/Control Protocol

Networking/Control Protocol (check all that apply):

Ethernet

802.11 WiFi

RS-232

RS-485

Other (please specify here):

Removable media (other than optical disc)

If checked, please indicate:

Types:

Status display

If checked, please indicate:

Resolution:

horizontal pixels

x

vertical pixels

Diagonal screen size:

inches

Hard disc drive

If checked, please indicate:

Speed:

RPM

Capacity:

GB

Optical disc drive

If checked, please indicate:

Type:

Indicator light

Remote control

If checked, please indicate:

Type:

Is auto power down (APD) enabled by default?

If not, is the product subject to 3rd party performance standards that prohibit APD, including those used for Mass Notification and Emergency Communications Systems thus subject to proposed ANSI/UL 2572?

If APD is enabled by default, then:

Default APD Timing after (1) the product ceases performance of all primary functions or (2) the last user input is received:

minutes

Can APD Timing be increased to >30 minutes?

Available APD settings (please list all that apply):

How are APD settings changed (please describe)?

Does the product have an external power supply (EPS)?

Is the EPS ENERGY STAR qualified?

If not, does the EPS meet the applicable no-load mode efficiency levels and power factor requirements provided in the latest version of the ENERGY STAR Program Requirements for Single Voltage External AC-AC and AC-DC Power Supplies?

EPS manufacturer name:

EPS model name:

EPS model number (if qualified, as it appears on the ENERGY STAR Qualified Product list):

Test Results

All Products

All tests were performed per the ENERGY STAR Audio/Video Test Procedure described in Appendix A of the Version 2.0 ENERGY STAR Program Requirements for Audio/Video. (check to affirm)

Was this product tested by the manufacturer?

If not, please specify the testing facility:

Date Tested (3/14/2009):

Is the user interface designed in accordance with IEEE 1621: Standard for User Interface Elements in Power Control of Electronic Devices Employed in Office/Consumer Environments?

For the remainder of this section, please report results for all applicable voltages.

Note: Products should be tested at all voltages corresponding to the markets in which they will be sold as ENERGY STAR qualified.

100V

115V

230V

Test Information

AC Mains Voltage:

Volts

AC Mains Frequency:

kHz

Test Temperature:

°C

Test Results

On Mode results - Average power consumption 2 minutes before APD:

watts

Sleep Mode results - Average power consumption 2 minutes after APD:

watts

APD Timing:

minutes

Time elapsed before APD event:

minutes

If several audio and video interconnections are available, the product successfully performs Auto Power Down for each interconnection option. (check to affirm)

Idle state power consumption:

watts

Sleep mode power consumption:

watts

Optical Disc Players (required if "Optical disc drive" is checked under Product Details)

Video Playback average power consumption:

SD Video Content:

watts

HD Video Content:

watts

Video Recording average power consumption:

SD Video Content:

watts

HD Video Content:

watts

Audio Playback average power consumption:

watts

Audio Recording average power consumption:

watts

Audio Amplifiers (required if "Audio amplification" is checked under Product Details)

Input Power at MUP:

watts

Input signal frequency (limited bandwidth amplifiers only):

kHz

Input Power at 1/8th MUP:

watts

Output Power: at 1/8th MUP:

watts

On Mode amplifier efficiency (small amplifiers)

%

On Mode amplifier efficiency (medium amplifiers)

%

On Mode amplifier efficiency (large amplifiers)

%

Product Labeling

Per the requirements in the ENERGY STAR Partnership Agreement, has the label been placed:

On the top/front of the product?

On product packaging?

On your Web site where the product information is displayed?

In product literature?

If labeling requirements cannot be met, please explain:

Qualification

By checking this box, I declare that the above information is, to the best of my knowledge, accurate and associated with the products included for qualification in this submittal. I understand that the ENERGY STAR Program will associate all data in this submittal with the products listed in this submittal upon receipt. I understand that if any of the above information is found to be inaccurate, the products will be removed from the ENERGY STAR qualified products list. I understand that intentionally submitting false information to the U.S. government is a criminal violation of the False Statements Act, Title 19 U.S.C. section 1001.

Date:

TERM DEFINITIONS

Product Classifications

AV Product: For purposes of this specification, all mains-connected products that offer audio amplification and/or optical disc drive functions and do not meet the definition of a Dedicated Audio DSP Device shall be classified as AV Products and subject to the requirements specified in this document.

Consumer AV Product: Consumer AV Products are intended for sale to individual consumers and include the following: cassette decks, CD players/changers, CD recorders/burners, clock radios, DVD & Blu-ray Disc products, equalizers, laserdisc players, mini- and midi-systems, minidisc players, powered speakers, rack systems, stereo amplifiers/pre-amplifiers, stereo receivers, table radios, and tuners.

Dedicated Audio DSP Device: A device may be classified as a “Dedicated Audio DSP Device” if it meets all of the following critieria: i) Provides audio digital signal processing as its primary function. ii) Provides support for RS232 or similar protocol for hard-wired remote control. iii) Does not provide audio amplification

Product Functions

Audio Amplification: A function by which a device increases the amplitude of an audio signal for purposes of sending the signal to a transducer for playback.

Audio Signal Processing: A function by which a device modifies an audio signal for a purpose other than amplification.

High Resolution Display: A function by which a device converts a video signal into a visual output (e.g. LCD panel, Plasma display panel).

Status Display: A function by which a product provides a visual display of less than 480x234 pixel resolution or 5 inches diagonal screen size. A typical status display would be a back-lit alphanumeric clock or channel indicator. Note that single indicator lamps are not included under the definition of status displays and are not provided power allowances under this specification.

Networking/Control Protocol: A function by which a device can connect to a network for transmission and receipt of data. The connection may be wired or wireless (e.g. WiFi, Ethernet, Bluetooth, RS-232, USB).

Optical Disc Player/Recorder: A function by which a device can read and/or write data to removable disc media (e.g. CD, DVD, Blu-ray Disc, and derivatives).

Other

APD (Auto Power Down): The capability to automatically switch a device from On mode to Sleep mode when all of the following criteria have been met: (1) the device has ceased performance of all primary functions, (2) the last user input has been received (e.g. remote control signal, volume adjustment), and (3) a predetermined period of time (APD timing) has elapsed.

EPS (External Power Supply): Also referred to as External Power Adapter. A component contained in a separate physical enclosure external to the AV product, designed to convert line voltage AC input from the mains to lower DC voltage(s) in order to provide power to the AV product. An EPS must connect to the AV product via a removable or hard-wired male/female electrical connection, cable, cord or other wiring.

High Definition Resolution: Video output with resolution greater than 480i/p.

Multi-component System: A product consisting of several components with separate enclosures that are sold as and intended for use as a single system. A “Home Theater in a Box” is an example of a Multi-component System.

The public reporting and recordkeeping burden for this collection of information is estimated to average 4.85 hours per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.