Form 5900-253 List of Products not eligible for ENERGY STAR

List of products not eligible for ENERGY STAR
All fields are required.
Please input only new ineligible products. Products you have previously reported via this form must not be included (except in the case of a new attempt to certify such a product).
When complete, please save and submit this document along with the laboratory test report, if applicable, and any supporting documentation to [email protected].
ENERGY STAR Manufacturing Partner	ENERGY STAR Product Manufacturer Organization ID	Brand name	Tested model name	Tested model number	Reason product is ineligible for ES (please attach lab test report or any supporting documentation)	Date CB notified manufacturer of ineligibility	ENERGY STAR specification	ENERGY STAR Specification Version	Date Tested	If family/series, additional models represented	Notes
United States ENVIRONMENTAL PROTECTION AGENCY Washington, DC 20460 Office of Atmospheric Programs
OMB Control No. 2060-0528
The public reporting and recordkeeping burden for this collection of information is estimated to average 5.2 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.