5900-226 ENERGY STAR Set-Top Box Service Provider Partner USD

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Overview

Service Providers PURCHASE Req.
Service Providers FLEET Req.

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Sheet 1: Service Providers PURCHASE Req.

	United States
	ENVIRONMENTAL PROTECTION AGENCY
	Washington, D.C. 20460
	ENERGY STAR® Set-Top Box Service Provider Partner Purchase 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.
• Please fill out either this sheet (Service Providers PURCHASE Req.) or the other sheet (Service Providers FLEET Req.), but not both.
• Report units of all ENERGY STAR qualified models deployed in the U.S. under your ENERGY STAR partnership.
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		Version 2.01 ENERGY STAR New Purchases2 (REQUIRED)	Version 3.03 ENERGY STAR New Purchases2 (REQUIRED)	TOTAL New Purchases2 (ENERGY STAR + Non-ENERGY STAR) (REQUIRED)
Cable
Satellite
Cable DTA
Internet Protocol (IP)
Terrestrial
Thin Client/Remote
Total Boxes		0	0	0
Number of Thin Client/Remote boxes reported in row 28 that have Deep Sleep Capability4
Number of Total boxes reported in row 29 that have Deep Sleep Capability
Total Boxes counted toward Partner Commitments (including premiums for Thin Client/Remote and boxes with Deep Sleep Capability)		0	0	0
1 This column applies to Set-top Boxes qualified to Version 2.0 (effective January 1, 2009 through August 31, 2011). Under Version 2.0, all Set-top Boxes counted equally toward meeting the Service Provider Partner Purchase Requirements. This is in contrast to Version 3.0.
2 Purchases shall be counted in the year in which Service Provider takes delivery.
3 This column applies to Set-top Boxes qualified to Version 3.0 (effective September 1, 2011). Under Version 3.0, Thin Clients and Set-top Boxes with Deep Sleep Capability receive a 50% premium (i.e., count as 1.5 boxes) toward meeting the Service Provider Partner Purchase Requirements.
4 Report unit purchases of Thin Client/Remote boxes with Deep Sleep Capability in this row. Premiums for Thin Client/Remote boxes and boxes with Deep Sleep Capability cannot be combined for a single Set-top Box. That is, a Thin Client/Remote box with Deep Sleep Capability can receive only one 50% premium (i.e., count as 1.5 boxes) toward meeting the Service Provider Partner Purchase Requirements.
Submission Deadline: March 1, 2012
To ICF International:
Elisabeth Alber
ICF International
1725 Eye Street, NW
Suite 1000
Washington, DC 20006
[email protected]
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. The third party must also submit to EPA the percent of ENERGY STAR qualified new purchases for each Service Provider partner according to the following equation: ENERGY STAR New Purchases in 2011/ TOTAL New Purchases in 2011.
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.

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Sheet 2: Service Providers FLEET Req.

	United States
	ENVIRONMENTAL PROTECTION AGENCY
	Washington, D.C. 20460
	ENERGY STAR® Set-Top Box Service Provider Partner Fleet 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.
• Please fill out either this sheet (Service Providers FLEET Req.) or the other sheet (Service Providers PURCHASE Req.), but not both.
• Report units of all ENERGY STAR qualified models deployed in the U.S. under your ENERGY STAR partnership.
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 New Purchases1 in Use2 (REQUIRED)	ENERGY STAR Refurbished3 STBs in Use2 (REQUIRED)	STBs Upgraded4 in the Field to ENERGY STAR in Use2 (REQUIRED)	TOTAL STBs in Use2 (ENERGY STAR + Non-ENERGY STAR) (REQUIRED)
Cable
Satellite
Cable DTA
Internet Protocol (IP)
Terrestrial
Thin Client/Remote
Total Boxes		0	0	0	0
1 Purchases shall be counted in the year in which Service Provider takes delivery.
2 In use by subscribers as of the close of calendar year 2011.
3 Refurbished refers to legacy boxes that are taken back by the Service Provider, brought into compliance with ENERGY STAR, and redeployed.
4 Upgraded refers to legacy boxes that are brought into compliance with ENERGY STAR in the field through a software update.
Submission Deadline: March 1, 2012
To ICF International:
Elisabeth Alber
ICF International
1725 Eye Street, NW
Suite 1000
Washington, DC 20006
[email protected]
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. The third party must also submit to EPA the percent of fleet that is ENERGY STAR qualified for each Service Provider partner according to the following equation: (ENERGY STAR New Purchases in Use + ENERGY STAR Refurbished STBs in Use + STBs Upgraded in the Field to ENERGY STAR in Use) / TOTAL ENERGY STAR and Non-ENERGY STAR STBs in Use.
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 3690
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.