5900-53 ENERGY STAR Roof Products Partner USD

United States
ENVIRONMENTAL PROTECTION AGENCY
Washington, D.C. 20460
ENERGY STAR Roof Products Partner Unit Shipment Data
Office of Atmospheric Programs
PARTNER NAME (Per your Partnership Agreement):
DATE OF SUBMISSION:
SUBMITTED BY (Your name):
IMPORTANT: Please read these instructions carefully before completing this form.
• Report shipments to or within the U.S. of all models qualified under your ENERGY STAR partnership.
• To ensure no double counting occurs, do not report shipments of products qualified under another company’s partnership, even if you are the Original Equipment Manufacturer of those products. As a reminder, any product sold under a brand name your company owns or licenses must be qualified under your ENERGY STAR partnership. To the extent you have labeled products as ENERGY STAR for a brand owner/licensee that is not an ENERGY STAR partner, please report your shipments of these products.
• If you shipped zero ENERGY STAR qualified models to or within the U.S. in 2011, please check here and leave the table below blank.
This form is programmed to calculate your total shipments. Therefore, EPA strongly encourages you to fill it out using Microsoft Excel, instead of filling out a printed copy. Estimates of shipments are not accepted. Product Type definitions are available in the Program Requirements at www.energystar.gov/specifications.
Reporting Period: CALENDAR YEAR 2011 (JAN. TO DEC.)
Roof Product Type	ENERGY STAR® U.S. Unit Shipments*	Units
Built-Up-Roof (BUR)		Square Feet
Coating		Gallons
Metal		Square Feet
Modified Bitumen		Square Feet
Single-Ply		Square Feet
Shingles		Square Feet
Spray Polyurethane Foam (SPF) Roof System#		Gallons
Tile		Square Feet
Total Gallons	0
Total Square Feet	0
#Data on the coating (i.e., not the foam itself)
*Unit Shipments in square feet or gallons, depending upon product type
Submission Deadline: March 1, 2012
Please submit either to SPRI:		Or	To ICF International:
Michael Egart			Elisabeth Alber
[email protected]			ICF International
(This option is available only to SPRI members.)			1725 Eye Street, NW
			Suite 1000
			Washington, DC 20006
			[email protected]
Do not submit form to both SPRI and ICF
EPA plans to use the data only for program evaluations. EPA will release this information only as aggregated data and only to the extent required by law.
The public reporting and recordkeeping burden for this collection of information is estimated to average 6.69 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.