Information Collection

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

IC 24482 under ICR 201601-2060-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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 5900-375 ENERGY STAR Program in the Commercial and Industrial Sectors - Private Sector Entities	Form and Instruction
5900-21 Small Business Network Form 5900-21_Small Business Network.doc www.energystar.gov/	Form and Instruction
5900-22 Statement of Energy Design Intent 5900-22_Statement of Energy Design Intent.docx www.energystar.gov/	Form
5900-198 Statement of Energy Improvement 5900-198_Statement of Energy Improvement.doc www.energystar.gov	Form
5900-89 Statement of Energy Performance - Plants 5900-89_Statement of Energy Performance - Plants.doc www.energystar.gov	Form
5900-195 SPP Partnership Agreement 5900-195_SPP Partnership Agreement.docx www.energystar.gov	Form and Instruction
5900-33 EEPS Partnership Agreement 5900-33_EEPS_Partnership_Agreement_ICR_12_31_2015.docx www.energystar.gov/	Form and Instruction
5900-19 C&I Partnership Letter 5900-19_C&I Partnership_Letter.doc www.energystar.gov/	Form
5900-263 Challenge for Industry Registration Form 5900-263_ENERGY STAR - Challenge for Industry Registration Form.docx www.energystar.gov	Form and Instruction
5900-262 Challenge for Industry Online Recognition Application 5900-262_ENERGY STAR - Challenge for Industry Recognition Application.docx www.energystar.gov	Form and Instruction
5900-265 EPI Award Specification Sheet 5900-265_Plant Award Specification Sheet.doc www.energystar.gov	Form
5900-264 EPI Award Application Letter 5900-264_Plant Award Application Letter.doc www.energystar.gov	Form and Instruction
5900-197 Data Checklist 5900-197_Data Checklist Form.pdf www.energystar.gov	Form
5900-375 Energy Data Verification Form 5900-375_Energy Data Verification Form_print ICR_12_31_2016.docx www.energystar.gov	Form and Instruction
5900-376 Final Team Energy Questoinnaire 5900-376_Final Team Energy Questionnaire_print ICR_12_31_2015.doc www.energystar.gov	Form and Instruction
5900-377 Final Energy Questionnaire 5900-377_Final Energy Questionnaire_print ICR_12_31_2015.doc www.energystar.gov	Form and Instruction
5900-378 Final Team Water Questionnaire 5900-378_Final Team Water Questionnaire_12_31_2015.doc www.energystar.gov	Form and Instruction
5900-379 Final Water Questionnaire 5900-379_Final Water Questionnaire_12_31_2015.doc www.energystar.gov	Form and Instruction
5900-380 Team Registration 5900-380_Team-Registration_12_31_2015.xlsx www.energystar.gov	Form and Instruction
5900-381 Water Data Verification 5900-381_Water Data Verification Form_12_31_2015.docx www.energystar.gov	Form and Instruction
5900-382 Spot Audit Form 5900-382_Spot Audit Form_ print ICR_12_31_2015.docx www.energystar.gov	Form and Instruction
5900-383 PE Verification Form 5900-383_PE Verification Form Appendix 3_12_31_2015.docx www.energystar.gov	Form and Instruction
5900-384 Letter of Intent_Architect of Record 5900-384_Letter Of Intent_Architect Of Record_print ICR_12_31_2015.docx www.energystar.gov	Form and Instruction
5900-385 Letter of Intent_Building Owner 5900-385_Letter Of Intent_Building Owner_print ICR_12_31_2015.doc www.energystar.gov	Form and Instruction
5900-386 Letter of Intent_Commercial Real Estate Developer 5900-386_Letter Of Intent_Commercial Real Estate Developer_12_31_2015.doc www.energystar.gov	Form and Instruction
5900-387 PE Verification Form 5900-387_PE Verification Form_ICR Appendix 6_12_31_2015.pdf www.energystar.gov	Form and Instruction

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 and Instruction	5900-375	Energy Data Verification Form	5900-375_Energy Data Verification Form_print ICR_12_31_2016.docx	www.energystar.gov	Yes	No	Fillable Printable
Form and Instruction	5900-376	Final Team Energy Questoinnaire	5900-376_Final Team Energy Questionnaire_print ICR_12_31_2015.doc	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-377	Final Energy Questionnaire	5900-377_Final Energy Questionnaire_print ICR_12_31_2015.doc	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-378	Final Team Water Questionnaire	5900-378_Final Team Water Questionnaire_12_31_2015.doc	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-379	Final Water Questionnaire	5900-379_Final Water Questionnaire_12_31_2015.doc	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-380	Team Registration	5900-380_Team-Registration_12_31_2015.xlsx	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-381	Water Data Verification	5900-381_Water Data Verification Form_12_31_2015.docx	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-382	Spot Audit Form	5900-382_Spot Audit Form_ print ICR_12_31_2015.docx	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-383	PE Verification Form	5900-383_PE Verification Form Appendix 3_12_31_2015.docx	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-384	Letter of Intent_Architect of Record	5900-384_Letter Of Intent_Architect Of Record_print ICR_12_31_2015.docx	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-385	Letter of Intent_Building Owner	5900-385_Letter Of Intent_Building Owner_print ICR_12_31_2015.doc	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-386	Letter of Intent_Commercial Real Estate Developer	5900-386_Letter Of Intent_Commercial Real Estate Developer_12_31_2015.doc	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-21	Small Business Network Form	5900-21_Small Business Network.doc	http://www.energystar.gov/	Yes	Yes	Fillable Fileable
Form	5900-22	Statement of Energy Design Intent	5900-22_Statement of Energy Design Intent.docx	http://www.energystar.gov/	Yes	Yes	Fillable Printable
Form	5900-198	Statement of Energy Improvement	5900-198_Statement of Energy Improvement.doc	www.energystar.gov	Yes	Yes	Fillable Printable
Form	5900-89	Statement of Energy Performance - Plants	5900-89_Statement of Energy Performance - Plants.doc	www.energystar.gov	Yes	No	Fillable Fileable
Form and Instruction	5900-195	SPP Partnership Agreement	5900-195_SPP Partnership Agreement.docx	https://www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-33	EEPS Partnership Agreement	5900-33_EEPS_Partnership_Agreement_ICR_12_31_2015.docx	http://www.energystar.gov/	Yes	Yes	Fillable Fileable
Form	5900-19	C&I Partnership Letter	5900-19_C&I Partnership_Letter.doc	https://www.energystar.gov/	Yes	Yes	Fillable Fileable
Form and Instruction	5900-263	Challenge for Industry Registration Form	5900-263_ENERGY STAR - Challenge for Industry Registration Form.docx	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-262	Challenge for Industry Online Recognition Application	5900-262_ENERGY STAR - Challenge for Industry Recognition Application.docx	www.energystar.gov	Yes	Yes	Fillable Fileable
Form	5900-265	EPI Award Specification Sheet	5900-265_Plant Award Specification Sheet.doc	www.energystar.gov	Yes	No	Fillable Printable
Form and Instruction	5900-264	EPI Award Application Letter	5900-264_Plant Award Application Letter.doc	www.energystar.gov	Yes	Yes	Fillable Printable
Form	5900-197	Data Checklist	5900-197_Data Checklist Form.pdf	www.energystar.gov	Yes	Yes	Fillable Fileable
Form and Instruction	5900-387	PE Verification Form	5900-387_PE Verification Form_ICR Appendix 6_12_31_2015.pdf	www.energystar.gov	Yes	Yes	Fillable Fileable

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: 31,733

Number of Respondents for Small Entity: 1,650

Affected Public: Private Sector

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

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	173,995	-148	39,071	135,072
Annual IC Time Burden (Hours)	157,365	-136	35,959	121,542
Annual IC Cost Burden (Dollars)	8,149,411	89,910	311,421	7,748,080

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.