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 for Calendar Year 2015
Office of Atmospheric Programs
PARTNER NAME (Per your Partnership Agreement):
PARTNER TYPE (Select from drop-down list or write-in OEM, Private Labeler, or OEM & Private Labeler):
If your company private labels product it receives from other ENERGY STAR Partners, please list those Partners here:
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 certified under your ENERGY STAR partnership.
• To ensure no double counting occurs, in the space provided above indicate whether you are an OEM and/or a private labeler, and:
―If you are a private labeler, in the space provided above list the OEM ENERGY STAR partners manufacturing the products you label, and in the table below report product you received from those partners and shipped in the U.S. as ENERGY STAR. ―If you are an OEM, in the table below report product your organization manufactured and shipped in the U.S. as ENERGY STAR. ―If you are both an OEM and private labeler, you should have shipments to report in both columns, adding up to your total shipments in the third column.
• If you shipped zero ENERGY STAR certified models to or within the U.S. in 2015, 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 2015 (JAN. TO DEC.)
Roof Product Type	OEM	PRIVATE LABELER	Totals2	Units
	Product your organization manufactured and shipped in the U.S. as ENERGY STAR®1	Product your organization received from other ENERGY STAR Partners and shipped in the U.S. as ENERGY STAR®
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 System3			-	Gallons
Tile			-	Square Feet
Total Gallons	-	-	-
Total Square Feet	-	-	-
1Unit Shipments in square feet or gallons, depending upon product type.
2 If using Excel, this column auto-sums the two values in columns B and C. If you are filling this out in hardcopy, ensure the value in this column is the sum of the values in columns B and C.
3 Data on the coating (i.e., not the foam itself).
Submission Deadline: March 1, 2016
Please submit either to ICF International:		Or	To SPRI:
Ranette Chrea			(This option is available only to SPRI members.)
ICF International			Michael Egart
1725 Eye Street, NW			[email protected]
Suite 1000
Washington, DC 20006
[email protected]
Do not submit form to both SPRI and ICF
EPA Form No. 5900-53 OMB Control No. 2060-0528 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 17 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.