Information Collection

Home Performance with Energy Star

IC 239144 under ICR 201912-1910-001 · OMB 1910-5184.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-5184 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DOE F 413.28 Home Performance with Energy Star	Form and Instruction
DOE F 413.28 Partnership Agreement 413.28 ENERGY_STAR_Participation_Form_EEPS.pdf	Form and Instruction
DOE F 413.29 Implementation Plan Template 413.29 HPwES_Program_Plan_Template.pdf	Form and Instruction
DOE F 413.30 HPwES Sponsor Biannual Report Template 413.30 HPwES_Biannual_Report_Template.xlsm	Form and Instruction
DOE F 413.31 HPwES Sponsor Annual Report Template 413.31 HPwES_Annual_Report_Template.xlsx	Form and Instruction
DOE F 413.32 Partner of the Year Application: Energy Efficiency Progr 413.32 2019ESAwards_PART 2-APP EnergyEfficiencyProgramDelivery.docx	Form and Instruction
DOE F 413.34 Home Performance with ENERGY STAR Contractor of the Year 413.34 2019ESAwards_PART 2-APP HPwESContractorOftheYear.docx	Form and Instruction

IC Title:

Home Performance with Energy Star

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DOE F 413.28	Partnership Agreement	413.28 ENERGY_STAR_Participation_Form_EEPS.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 413.29	Implementation Plan Template	413.29 HPwES_Program_Plan_Template.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 413.30	HPwES Sponsor Biannual Report Template	413.30 HPwES_Biannual_Report_Template.xlsm	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 413.31	HPwES Sponsor Annual Report Template	413.31 HPwES_Annual_Report_Template.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 413.32	Partner of the Year Application: Energy Efficiency Program Delivery Template	413.32 2019ESAwards_PART 2-APP EnergyEfficiencyProgramDelivery.docx	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 413.34	Home Performance with ENERGY STAR Contractor of the Year Template	413.34 2019ESAwards_PART 2-APP HPwESContractorOftheYear.docx	Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Conservation and Preparedness

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 29

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	168	168
Annual IC Time Burden (Hours)	1,143	1,143
Annual IC Cost Burden (Dollars)	75,975	75,975

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.