5900-163 ENERGY STAR Imaging Equipment Partner USD

United States
ENVIRONMENTAL PROTECTION AGENCY
Washington, D.C. 20460
ENERGY STAR Imaging Equipment Partner Unit Shipment Data
	Unit Shipment Data for Calendar Year 2015
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 certified under your ENERGY STAR partnership.
• To ensure no double counting occurs, do not report shipments of products certified 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 certified under your ENERGY STAR partnership.
• 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.)
Imaging Equipment Product Type		ENERGY STAR® U.S. Unit Shipments
Copiers		-
Qualified by OM
Large Format, Color or Mono (DS, DT, EP, SI, TT)
Qualified by TEC
Standard Format, Color or Mono (DS, DT, EP, SI, TT)
Digital Duplicators
Fax Machines		-
Qualified by OM
Ink Jet Standard Format, Color or Mono
Qualified by TEC
Non-ink Jet Standard Format, Color or Mono (DS, DT, EP, SI, TT)
Mailing Machines
Multifunction Devices (MFDs) and Printers		-
Qualified by OM		-
Impact Standard Format MFDs and Printers, Color or Mono
Ink Jet Standard Format MFDs and Printers, Color or Mono
Ink Jet Large Format MFDs and Printers, Color or Mono (Excludes High Performance IJ)
Non-Ink Jet Large Format MFDs and Printers, Color or Mono (DS, DT, EP, Impact, High Performance IJ, SI, TT)
Non-High Performance Ink Jet Small Format Printers Only, Color or Mono (DS, DT, EP, Impact, IJ, SI, TT)
Qualified by TEC		-
Color Standard Format Total MFDs and Printers (DS, DT, EP, High Performance IJ, SI, TT)		-
≤ 32 IPM
33 - 58 IPM
≥ 59 IPM
Mono Standard Format Total MFDs Only (DS, DT, EP, High Performance IJ, TT)		-
≤ 26 IPM
≥ 27 IPM
Mono Standard Format Total Printers Only (DS, DT, EP, High Performance IJ, TT)		-
≤ 15 IPM
16 - 40 IPM
≥ 41 IPM
High Performance Ink Jet Small Format Printers Only, Color or Mono
Scanners
Total		-
Submission Deadline: March 1, 2016
Please submit to either ICF International:	Or	To Information Technology Institute:
Ranette Chrea		Joseph Andersen
ICF International		[email protected]
1725 Eye Street, NW
Suite 1000
Washington, DC 20006
[email protected]
Do not submit form to both ITI and ICF
EPA Form No. 5900-163 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.