Information Collection

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

IC 24482 under ICR 201301-2060-010 · 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⚠️ Notice: This information collection may be referencing outdated material.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 5900-20 ENERGY STAR Program in the Commercial and Industrial Sectors - Private Sector Entities	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
5900-21 Small Business Network Form Small Business Network.doc www.energystar.gov/index.cfm?c=small_business.sb_partner_info_form	Form and Instruction
5900-22 Statement of Energy Design Intent Statement of Energy Design Intent.docx www.energystar.gov/ia/business/tools_resources/target_finder/help/Statement_of_Energy_Design_Intent.htm	Form
5900-198 Statement of Energy Improvement Statement of Energy Improvement.doc www.energystar.gov	Form
5900-89 Statement of Energy Performance - Plants Statement of Energy Performance - Plants.doc www.energystar.gov	Form
5900-195 SPP Partnership Agreement SPP Partnership Agreement.docx www.energystar.gov/index.cfm?fuseaction=opa.showPartnershipCategory&p_code=SP&newAgreement=true	Form and Instruction
5900-33 EEPS Partnership Agreement EEPS_Partnership_Agreement.docx www.energystar.gov/ia/about/join/EEPS_Partnership_Agreement.pdf?0c90-dd4a	Form and Instruction
5900-19 C&I Partnership Letter C&I Partnership_Letter.doc www.energystar.gov/index.cfm?fuseaction=opa.showPartnershipApplicationChecklist&p_code=ESB&associations=false&newAgreeme	Form
5900-263 Challenge for Industry Registration Form ENERGY STAR - Challenge for Industry Registration Form.docx docs.google.com	Form and Instruction
5900-262 Challenge for Industry Online Recognition Application ENERGY STAR - Challenge for Industry Recognition Application.docx docs.google.com	Form and Instruction
5900-265 EPI Award Specification Sheet Plant Award Specification Sheet.doc www.energystar.gov	Form
5900-264 EPI Award Application Letter Plant Award Application Letter.doc www.energystar.gov	Form and Instruction
5900-197 Data Checklist Data Checklist.pdf www.energystar.gov	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

ENERGY STAR Program in the Commercial and Industrial Sectors - Private 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	5900-20	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 and Instruction	5900-21	Small Business Network Form	Small Business Network.doc	http://www.energystar.gov/index.cfm?c=small_business.sb_partner_info_form	Yes	Yes	Fillable Fileable
Form	5900-22	Statement of Energy Design Intent	Statement of Energy Design Intent.docx	http://www.energystar.gov/ia/business/tools_resources/target_finder/help/Statement_of_Energy_Design_Intent.htm	Yes	No	Fillable Printable
Form	5900-198	Statement of Energy Improvement	Statement of Energy Improvement.doc	www.energystar.gov	Yes	No	Fillable Printable
Form	5900-89	Statement of Energy Performance - Plants	Statement of Energy Performance - Plants.doc	www.energystar.gov	Yes	No	Fillable Printable
Form and Instruction	5900-195	SPP Partnership Agreement	SPP Partnership Agreement.docx	https://www.energystar.gov/index.cfm?fuseaction=opa.showPartnershipCategory&p_code=SP&newAgreement=true	Yes	Yes	Fillable Fileable
Form and Instruction	5900-33	EEPS Partnership Agreement	EEPS_Partnership_Agreement.docx	http://www.energystar.gov/ia/about/join/EEPS_Partnership_Agreement.pdf?0c90-dd4a	Yes	Yes	Fillable Fileable
Form	5900-19	C&I Partnership Letter	C&I Partnership_Letter.doc	https://www.energystar.gov/index.cfm?fuseaction=opa.showPartnershipApplicationChecklist&p_code=ESB&associations=false&newAgreement=true	Yes	Yes	Fillable Fileable
Form and Instruction	5900-263	Challenge for Industry Registration Form	ENERGY STAR - Challenge for Industry Registration Form.docx	https://docs.google.com	Yes	Yes	Fillable Fileable
Form and Instruction	5900-262	Challenge for Industry Online Recognition Application	ENERGY STAR - Challenge for Industry Recognition Application.docx	https://docs.google.com	Yes	Yes	Fillable Fileable
Form	5900-265	EPI Award Specification Sheet	Plant Award Specification Sheet.doc	www.energystar.gov	Yes	No	Fillable Printable
Form and Instruction	5900-264	EPI Award Application Letter	Plant Award Application Letter.doc	www.energystar.gov	Yes	No	Fillable Printable
Form	5900-197	Data Checklist	Data Checklist.pdf	www.energystar.gov	Yes	Yes	Fillable Printable

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: 10,366

Number of Respondents for Small Entity: 1,650

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions, Farms

Percentage of Respondents Reporting Electronically: 99 %

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	135,072	117	105,736	29,219
Annual IC Time Burden (Hours)	121,542	48	43,447	78,047
Annual IC Cost Burden (Dollars)	7,748,080	11,900	3,254,236	4,481,944

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.