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Water Efficiency Collection - Private Sector
EPA's WaterSense Program (Renewal)
OMB: 2040-0272
IC ID: 46015
OMB.report
EPA/OW
OMB 2040-0272
ICR 201903-2040-003
IC 46015
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2040-0272 can be found here:
2021-06-30 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 6100-06
Water Efficiency Collection - Private Sector
Form and Instruction
Attachment 21_Awards Statement_Promotional Partner.pdf
Instruction
Attachment 16_Awards Statement_Builder.pdf
Instruction
Attachment 19_Awards Statement_Manufacturer.pdf
Instruction
Attachment 22_Awards Statement_Retailer-Distributor.pdf
Instruction
Attachment 18_Awards Statement_Licensed Certification Provider.pdf
Instruction
Attachment 20_Awards Statement_Professional Certifying Organization.pdf
Instruction
6100-06 Partnership Agreement - Promotional
Attachment 6_Partnership Agreement_Promotional Partner.pdf
www.epa.gov/watersense/docs/ws_partnership_promo_508_2-1-13.pdf
Form and Instruction
6100-12 Partnership Agreement - Retail/Distributor
Attachment 7_Partnership Agreement_Retailer-Distributor.pdf
www.epa.gov/watersense/docs/ws_partnership_retail-distributors_508_2-1-13.pdf
Form and Instruction
6100-13 Partnership Agreement - Manufacturer
Attachment 4_Partnership Agreement_Manufacturer.pdf
www.epa.gov/watersense/docs/ws_partnership_manufacturers_508_2-1-13.pdf
Form and Instruction
6100-07 Partnership Agreement - Professional Certifying Organiza
Attachment 5_Partnership Agreement_Professional Certifying Organization.pdf
www.epa.gov/watersense/docs/ws_partnership_certorgs_508_2-1-13.pdf
Form and Instruction
6100-19 Partnership Agreement - Builder
Attachment 1_Partnership Agreement_Builder.pdf
www.epa.gov/watersense/docs/partnership_builder508w.pdf
Form and Instruction
6100-20 Partnership Agreement - Licensed Certification Provider
Attachment 3_Partnership Agreement_Licensed Certification Provider.pdf
www.epa.gov/watersense/docs/partnership_provider508w.pdf
Form and Instruction
6100-09 Annual Reporting Form - Manufacturer Plumbing Hard Copy
Attachment 13_Annual Reporting_Manufacturer_Hard Copy.pdf
Form and Instruction
6100-09 Annual Reporting Form - Promotional
Attachment 11_Annual Reporting_Promotional.pdf
Form and Instruction
6100-09 Annual Reporting Form - Retail/Distributor
Attachment 12_Annual Reporting_Retailer-Distributor.pdf
Form and Instruction
6100-09 Annual Reporting Form - Retail/Distributor Hard Copy
Attachment 15_Annual Reporting_Retailer-Distributor_Hard Copy.pdf
Form and Instruction
6100-09 Annual Reporting Form - Manufacturer Plumbing
Attachment 9_Annual Reporting_Manucturer.pdf
Form and Instruction
6100-09 Annual Reporting Form - Manufacturer WBIC
Attachment 10_Annual Reporting_Manufacturer WBIC.PDF
Form and Instruction
6100-09 Annual Reporting Form - Manufacturer WBIC Hard Copy
Attachment 14_Annual Reporting_Manufacturer WBIC_Hard Copy.pdf
Form and Instruction
6100-09 Annual Reporting Form - Builder
Attachment 8_Annual Reporting_Builder-rev.pdf
Form and Instruction
6100-09 Quarterly Reporting Form - Licensed Certficiation Provid
Attachment 30_Provider Quarterly Reporting Form.pdf
Form and Instruction
6100-17 Awards Application Form - Promotional
Attachment 28_Awards Form_Promotional Partner.pdf
Form and Instruction
6100-17 Awards Application Form - Builder
Attachment 23_Awards Form_Builder.pdf
Form and Instruction
6100-17 Awards Application Form - Manufacturer
Attachment 26_Awards Form_Manufacturer.pdf
Form and Instruction
6100-17 Awards Application Form - Retail/Distributor
Attachment 29_Awards Form_Retailer-Distributor.pdf
Form and Instruction
6100-17 Awards Application Form - Licensed Certification Provide
Attachment 25_Awards Form_Licensed Certification Provider.pdf
Form and Instruction
6100-17 Awards Application Form - Professional Certifying Organi
Attachment 27_Awards Form_Professional Certifying Organization.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Water Efficiency Collection - Private Sector
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
6100-06
Partnership Agreement - Promotional
Attachment 6_Partnership Agreement_Promotional Partner.pdf
http://www.epa.gov/watersense/docs/ws_partnership_promo_508_2-1-13.pdf
Yes
Yes
Fillable Printable
Form and Instruction
6100-12
Partnership Agreement - Retail/Distributor
Attachment 7_Partnership Agreement_Retailer-Distributor.pdf
http://www.epa.gov/watersense/docs/ws_partnership_retail-distributors_508_2-1-13.pdf
Yes
Yes
Fillable Printable
Form and Instruction
6100-13
Partnership Agreement - Manufacturer
Attachment 4_Partnership Agreement_Manufacturer.pdf
http://www.epa.gov/watersense/docs/ws_partnership_manufacturers_508_2-1-13.pdf
Yes
Yes
Fillable Printable
Form and Instruction
6100-07
Partnership Agreement - Professional Certifying Organizatons
Attachment 5_Partnership Agreement_Professional Certifying Organization.pdf
http://www.epa.gov/watersense/docs/ws_partnership_certorgs_508_2-1-13.pdf
Yes
Yes
Fillable Printable
Form and Instruction
6100-19
Partnership Agreement - Builder
Attachment 1_Partnership Agreement_Builder.pdf
http://www.epa.gov/watersense/docs/partnership_builder508w.pdf
Yes
Yes
Fillable Printable
Form and Instruction
6100-20
Partnership Agreement - Licensed Certification Provider
Attachment 3_Partnership Agreement_Licensed Certification Provider.pdf
http://www.epa.gov/watersense/docs/partnership_provider508w.pdf
Yes
Yes
Fillable Printable
Form and Instruction
6100-09
Annual Reporting Form - Manufacturer Plumbing Hard Copy
Attachment 13_Annual Reporting_Manufacturer_Hard Copy.pdf
Yes
No
Fillable Printable
Form and Instruction
6100-09
Annual Reporting Form - Promotional
Attachment 11_Annual Reporting_Promotional.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
6100-09
Annual Reporting Form - Retail/Distributor
Attachment 12_Annual Reporting_Retailer-Distributor.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
6100-09
Annual Reporting Form - Retail/Distributor Hard Copy
Attachment 15_Annual Reporting_Retailer-Distributor_Hard Copy.pdf
Yes
No
Fillable Printable
Form and Instruction
6100-09
Annual Reporting Form - Manufacturer Plumbing
Attachment 9_Annual Reporting_Manucturer.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
6100-09
Annual Reporting Form - Manufacturer WBIC
Attachment 10_Annual Reporting_Manufacturer WBIC.PDF
Yes
Yes
Fillable Fileable
Form and Instruction
6100-09
Annual Reporting Form - Manufacturer WBIC Hard Copy
Attachment 14_Annual Reporting_Manufacturer WBIC_Hard Copy.pdf
Yes
No
Fillable Printable
Form and Instruction
6100-09
Annual Reporting Form - Builder
Attachment 8_Annual Reporting_Builder-rev.pdf
Yes
No
Fillable Fileable
Form and Instruction
6100-09
Quarterly Reporting Form - Licensed Certficiation Providers
Attachment 30_Provider Quarterly Reporting Form.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
6100-17
Awards Application Form - Promotional
Attachment 28_Awards Form_Promotional Partner.pdf
Yes
Yes
Fillable Fileable
Instruction
Attachment 21_Awards Statement_Promotional Partner.pdf
Yes
No
Printable Only
Form and Instruction
6100-17
Awards Application Form - Builder
Attachment 23_Awards Form_Builder.pdf
Yes
Yes
Fillable Fileable
Instruction
Attachment 16_Awards Statement_Builder.pdf
Yes
No
Printable Only
Form and Instruction
6100-17
Awards Application Form - Manufacturer
Attachment 26_Awards Form_Manufacturer.pdf
Yes
Yes
Fillable Fileable
Instruction
Attachment 19_Awards Statement_Manufacturer.pdf
Yes
No
Printable Only
Form and Instruction
6100-17
Awards Application Form - Retail/Distributor
Attachment 29_Awards Form_Retailer-Distributor.pdf
Yes
Yes
Fillable Fileable
Instruction
Attachment 22_Awards Statement_Retailer-Distributor.pdf
Yes
No
Printable Only
Form and Instruction
6100-17
Awards Application Form - Licensed Certification Provider
Attachment 25_Awards Form_Licensed Certification Provider.pdf
Yes
Yes
Fillable Fileable
Instruction
Attachment 18_Awards Statement_Licensed Certification Provider.pdf
Yes
No
Printable Only
Form and Instruction
6100-17
Awards Application Form - Professional Certifying Organization
Attachment 27_Awards Form_Professional Certifying Organization.pdf
Yes
Yes
Fillable Fileable
Instruction
Attachment 20_Awards Statement_Professional Certifying Organization.pdf
Yes
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Environmental Management
Subfunction:
Environmental Remediation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
265
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
80 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
265
0
0
48
0
217
Annual IC Time Burden (Hours)
964
0
-8
150
0
822
Annual IC Cost Burden (Dollars)
271
0
0
15
0
256
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.