Superior Energy Performance Certification Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DOE HQ F 413 Superior Energy Performance	Form and Instruction	New	Available
Exec Order August 30 2012.docx	Supplementary Document	Uploaded 2015-03-31	Available
2015-02-18_SEP Summary of Annual Burden Hours_v2.docx	Supplementary Document	Uploaded 2015-03-31	Available
2015-02-27_Supporting Statement B_FINAL.docx	Supporting Statement B	Uploaded 2015-03-31	Available
30 Day FRN Published 12-10-14.pdf	Supplementary Document	Uploaded 2014-12-19	Available
60 Day FRN Published 6-27-14.pdf	Supplementary Document	Uploaded 2014-12-19	Available
2014-12-16_SEP Summary of Annual Burden Hours.docx	Supplementary Document	Uploaded 2014-12-19	Available
2014-12-16_Overview of Data Collection Forms.docx	Supplementary Document	Uploaded 2014-12-19	Available
2015-03-30_Supporting Statement_A_FINAL.docx	Supporting Statement A	Uploaded 2015-03-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
214346	Superior Energy Performance	Form and Instruction	New

ICR Details

OMB Control No: 1910-5177	ICR Reference No: 201412-1910-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOE/DOEOA	Agency Tracking No: Paul Scheihing (EE)
Title: Superior Energy Performance Certification Program
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/01/2015
	Date Received in OIRA: 01/07/2015
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years with the following terms of clearance: as this is a new information collection request, the agency should update the forms with the OMB assigned control number and expiration date prior to issuing any of the forms to the public.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2018	36 Months From Approved
Responses	475	0	0
Time Burden (Hours)	650	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The President's Executive Order -- Accelerating Investment in Industrial Energy Efficiency (Aug. 2012.) calls for DOE and other Federal agencies to facilitate energy efficiency investments at industrial facilities by providing technical assistance and public information on the benefits of such investments, and using existing Federal programs to support these investments. This collection enables DOE to meet this order and quantify the costs and benefits of investments in energy efficiency.

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Authorizing Statute(s): EO: EO 13624 Name/Subject of EO: Accelerating Investment in Industrial Energy Efficiency
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 36497	06/27/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 73284	12/10/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Superior Energy Performance	DOE HQ F 413, DOE HQ F 413.1, DOE HQ F 413.2, DOE HQ F 413.3	Superior Energy Performance Enrollment ,   Superior Energy Performance Application ,   Superior Energy Performance Improvement Report ,   Superior Energy Performance Voluntary Cost Benefit

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	475	0	0	0	475	0
Annual Time Burden (Hours)	650	0	0	0	650	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $41,250

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/07/2015

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