CBECS (Voluntary) (OMB 1905-0145)

CIPSEA Confidentiality Pledge Revision

Documents and Forms

Document Name Document Type
Form EIA-871A CBECS (Voluntary) (OMB 1905-0145) Form and Instruction
EIA-871A Building Questionnaire 2012 CBECS - Form 871A - Building Questionnaire.doc www.eia.gov/survey/#eia-871 Form and Instruction
EIA-871B Authorization Form Authorization Form 2012 871B.docx Form and Instruction
EIA-871I Mall Building Questionnaire 2012 CBECS - Form 871I - Mall Building Questionnaire.doc Form and Instruction
EIA-871J Mall Establishment Questionnaire 2012 CBECS - Form 871J - Mall Establishment Questionnaire.doc Form and Instruction
EIA-871G Characteristics, Energy Sources, and Equipment Worksheet 1 building 2012 871G.docx Form and Instruction
EIA-871H Energy Amounts Used and Dollars Spent Worksheet 2 building 2012 871H.docx Form and Instruction

Information Collection (IC) Details

IC Title:	CBECS (Voluntary) (OMB 1905-0145)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	EIA-871A	Building Questionnaire	2012 CBECS - Form 871A - Building Questionnaire.doc	https://www.eia.gov/survey/#eia-871	Yes	No	Fillable Printable
Form and Instruction	EIA-871B	Authorization Form	Authorization Form 2012 871B.docx		No		Fillable Printable
Form and Instruction	EIA-871I	Mall Building Questionnaire	2012 CBECS - Form 871I - Mall Building Questionnaire.doc		No		Fillable Printable
Form and Instruction	EIA-871J	Mall Establishment Questionnaire	2012 CBECS - Form 871J - Mall Establishment Questionnaire.doc		No		Fillable Printable
Form and Instruction	EIA-871G	Characteristics, Energy Sources, and Equipment	Worksheet 1 building 2012 871G.docx		No		Fillable Printable
Form and Instruction	EIA-871H	Energy Amounts Used and Dollars Spent	Worksheet 2 building 2012 871H.docx		No		Fillable Printable

Line of Business: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 800	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	800	800
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.