5900-206 ENERGY STAR? Set-Top Box Manufacturer Partner USD

	United States
	ENVIRONMENTAL PROTECTION AGENCY
	Washington, D.C. 20460
	ENERGY STAR® Set-Top Box Manufacturer 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.)
Set-top Box Functionality		ENERGY STAR® U.S. Unit Shipments to Consumers or Retailers* (REQUIRED)	ENERGY STAR® U.S. Unit Shipments to Service Providers that are ENERGY STAR Partners (REQUIRED)	Version 2.0 ENERGY STAR® U.S. Unit Shipments to Service Providers that are not ENERGY STAR Partners** (REQUIRED)	Version 3.0 ENERGY STAR® U.S. Unit Shipments to Service Providers that are not ENERGY STAR Partners*** (REQUIRED)
Cable
Satellite
Cable DTA
Internet Protocol (IP)
Terrestrial
Thin Client/Remote
Total Boxes		0	0	0	0
# of above boxes with:
Advanced Video Processing
CableCARD™
Digital Video Recorder (DVR)
DOCDIS®
High Definition (HD)
Home Network Interface
Multi-room
Multi-stream/Additional Tuners (Cable/Satellite)
Multi-stream/Additional Tuners (Terrestrial/IP)
Removable Media Player
Removable Media Player/Recorder
Deep Sleep Capability
Automatic Power Down (APD) to Sleep Mode Enabled by Default
Automatic Power Down (APD) to Deep Sleep State Enabled by Default
* This column shall include units that may be purchased without signing up for a service plan from a Service Provider. Other set-top boxes available at retail but not operable without a service agreement shall be reported in the "Service Providers that are ENERGY STAR Partners" column.
** This column applies to Set-top Boxes qualified to Version 2.0 (effective January 1, 2009 through August 31, 2011). Under Version 2.0, Manufacturing Partners could not label ENERGY STAR qualified units when sold to non-ENERGY STAR Service Provider Partners.
*** This column applies to Set-top Boxes qualified to Version 3.0 (effective September 1, 2011). With Version 3.0, Manufacturing Partners can sell or distribute ENERGY STAR qualified and labeled units to non-ENERGY STAR Service Provider Partners, if they continue to meet ENERGY STAR eligibility criteria in all possible hardware and software configurations. This is in contrast to Version 2.0, under which Manufacturing Partners could NOT label units as ENERGY STAR when selling or distributing to non-ENERGY STAR Service Provider Partners.
Submission Deadline: March 1, 2012
Please submit either to CEA:		Or		To ICF International:
Chris Ely				Elisabeth Alber
[email protected]				ICF International
				1725 Eye Street, NW
				Suite 1000
				Washington, DC 20006
				[email protected]
Do not submit form to both CEA and ICF
For additional protection of confidential business information, partners may elect to submit the above information to a third party for aggregation prior to submission to EPA. If this path is chosen, the third party must submit to EPA the above table of information containing the summary data received from partners and a list of partners that contributed to the data collection effort.
Any information submitted to EPA for which a claim of confidentiality is made will be safeguarded according to the Agency policies set forth in Title 40, chapter 1, part 1, subpart B - Confidentiality of Business Information (see 40 CFR part 2; 41 FR 36902, September 1, 1976; amended by 43 FR 40000, September 8, 1978; 43 FR 42251, September 20, 1978; 44 FR 17674, March 23, 1979).
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.