5900-163 ENERGY STAR Imaging Equipment Unit Shipment Data Co

United States
ENVIRONMENTAL PROTECTION AGENCY
Washington, D.C. 20460
ENERGY STAR Imaging Equipment Partner Unit Shipment Data for Calendar Year 2018
Office of Atmospheric Programs
PARTNER NAME (Per your Partnership Agreement):				← Partner Name incomplete
SUBMITTED BY (Your name):				← Submitted By incomplete
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.
This form is programmed to calculate your total shipments. Therefore, EPA strongly encourages you to complete it 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.
If you shipped zero ENERGY STAR certified models to or within the U.S. in 2018, please check here and leave the table below blank.			← Check box indicating zero shipments OR report shipments
Reporting Period: CALENDAR YEAR 2018 (JAN. TO DEC.)
Imaging Equipment Product Type	ENERGY STAR® U.S. Unit Shipments
Copiers
Digital Duplicators
Fax Machines
Mailing Machines
Multifunction Devices (MFDs)	-
Large Format, Color or Mono
Standard Format, EP	-
Standard Format, EP, Color
Standard Format, EP, Mono
Standard Format, Ink Jet, Color or Mono
Standard Format, High Performance Ink Jet, Color or Mono
Standard Format, All Other, Color or Mono
Printers	-
Small Format, Color or Mono
Large Format, Color or Mono
Standard Format, EP	-
Standard Format, EP, Color
Standard Format, EP, Mono
Standard Format, Ink Jet, Color or Mono
Standard Format, High Performance Ink Jet, Color or Mono
Standard Format, All Other, Color or Mono
Scanners
Total	-
Submission Deadline: March 1, 2019
Please submit to ICF:	Or	To Information Technology Industry Council:
Matt Bugajski		Erica Logan
ICF		[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 17.5 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.