Information Collection

Superior Energy Performance

IC 214346 under ICR 202110-1910-007 · OMB 1910-5177.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-5177 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DOE HQ F 413.37 Superior Energy Performance	Form and Instruction
DOE HQ F 413.37 SEP 50001 Application DOE F 413.37 SEP_50001_Application.docx	Form and Instruction
DOE HQ F 413.2 SEP 50001 Energy Performance Improvement Report DOE F 413.2 SEP 50001 Energy Performance Improvement Report.xlsx	Form and Instruction
DOE HQ F 413.40 SEP 50001 Scorecard Declaration DOE HQ F 413.40 SEP_50001_Scorecard_Declaration.xlsx	Form and Instruction
DOE F 413.39 50001 Ready Self-Attestation Form DOE F 413.39 50001 Ready Self-Attestation Form.docx	Form and Instruction
DOE HQ F 413.41 50001 Ready Energy Performance Improvement Report DOE HQ F 413.41 50001 Ready Energy Performance Improvement Report.xlsx	Form and Instruction

IC Title:

Superior Energy Performance

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 HQ F 413.37	SEP 50001 Application	DOE F 413.37 SEP_50001_Application.docx	Yes	Yes	Fillable Fileable
Form and Instruction	DOE HQ F 413.2	SEP 50001 Energy Performance Improvement Report	DOE F 413.2 SEP 50001 Energy Performance Improvement Report.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	DOE HQ F 413.40	SEP 50001 Scorecard Declaration	DOE HQ F 413.40 SEP_50001_Scorecard_Declaration.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 413.39	50001 Ready Self-Attestation Form	DOE F 413.39 50001 Ready Self-Attestation Form.docx	Yes	Yes	Fillable Fileable
Form and Instruction	DOE HQ F 413.41	50001 Ready Energy Performance Improvement Report	DOE HQ F 413.41 50001 Ready Energy Performance Improvement Report.xlsx	Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 450

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
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	450	217	233
Annual IC Time Burden (Hours)	450	117	333
Annual IC Cost Burden (Dollars)	31,452	12,785	18,667

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.