EPA's ENERGY STAR Product Labeling (Renewal)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 5900-251 Verification Testing Summary Report	Form and Instruction	Modified	Available
Form 5900-253 Ineligible Product Form	Form and Instruction	Modified	Repair queued
Form 5900-252 Failure Report	Form and Instruction	Modified	Available
Form 5900-252 Third Party Certified Product Information	Form and Instruction	Modified	Repair queued
Form 5900-440 Windows Application	Form and Instruction	Modified	Repair queued
Form 5900-439 Most Efficient HVAC Application	Form and Instruction	Modified	Repair queued
Form 5900-439 Most Efficient	Form and Instruction	Modified	Repair queued
Form 5900-254 Partner Response Form Non-Disputable	Form and Instruction	Modified	Repair queued
Form 5900-254 Partner Response Form Lighting	Form and Instruction	Modified	Repair queued
Form 5900-254 Partner Response Form Disputable	Form and Instruction	Modified	Repair queued
Form 5900-254 Partner Response Form Certification Errors	Form and Instruction	Modified	Repair queued
Form 5900-254 Partner Response Forms (PRFs)	Form and Instruction	Modified	Repair queued
Form 5900-255 WMTLs SMTLs Data Entry	Form and Instruction	Modified	Repair queued
Form 5900-218 Application Certification Body	Form and Instruction	Modified	Repair queued
Form 5900-217 Application Accredited Laboratory	Form and Instruction	Modified	Repair queued
Form 5900-216 Application Accreditation Body	Form and Instruction	Modified	Repair queued
Form 5900-216 Application for AB, CB, Lab, and W/SMTL Recognition and Scope Expansion	Form and Instruction	Modified	Repair queued
Form 5900-33 Participation Form Brand Owner	Form and Instruction	Modified	Repair queued
Form 5900-35 Participation Form EEPS	Form and Instruction	Modified	Repair queued
Form 5900-33 Partnership Agreement	Form and Instruction	Modified	Repair queued
Form 5900-34 Retailers Participation Form	Form and Instruction	Modified	Repair queued
Form 5900-34 Partnership Applications	Form and Instruction	Modified	Repair queued
Form 5900-34 Part 2 Product Brand Owner	Form and Instruction	Modified	Repair queued
Form 5900-34 App Retailer	Form and Instruction	Modified	Repair queued
Form 5900-34 Product Brand Owner	Form and Instruction	Modified	Repair queued
Form 5900-34 ES Marketing	Form and Instruction	Modified	Repair queued
Form 5900-34 Energy Efficiency Program Delivery	Form and Instruction	Modified	Repair queued
Form 5900-34 Instruction - Executive Summary	Form and Instruction	Modified	Repair queued
Form 5900-34 Partner of the Year Award Applicaiton	Form and Instruction	Modified	Repair queued
Form 5900-228 Water Heaters Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-58 Water Coolers Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-57 Ventilating Fans Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-56 Vending Machines Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-47 Uninterruptible Power Supply Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-55 Televisions Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-54 Telephony Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-206 Set Top Boxes Data Collection Form	Form and Instruction	Modified	Available
Form 5900-234 Room Air Conditioners Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-35 Room Air Cleaners Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-230 Refrigerators and Freezers Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-348 Pool Pumps Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-235 Luminaires Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-50 Light Commercial HVAC Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-229 Lamps Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-417 Laboratory Grade Refrigerators and Freezers Data Collection	Form and Instruction	Modified	Repair queued
Form 5900-163 Imaging Equipment Data Collection Form	Form and Instruction	Modified	Available
Form 5900-49 Geothermal Heat Pumps Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-48 Furnaces Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900438 Electric Vehicle Supply Equipment Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-51 Displays Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-224 Dishwashers Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-43 Dehumidifiers Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-166 Decorative Light Strings Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-350 Data Center Storage Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-416 Connected Thermostats Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-165 Computers Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-165 Computer Servers Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-351 Commercial Water Heaters Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-44 Commercial Steam Cookers Data Collection Form	Form and Instruction	Modified	Available
Form 5900-39 Commercial Refrigerators and Freezers Data Collection	Form and Instruction	Modified	Repair queued
Form 5900-28 Commercial Ovens Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-168 Commercial Ice Machines Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-41 Commercial Hot Food Holding Cabinets Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-208 Commercial Griddles Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-42 Commercial Fryers Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-164 Commercial Dishwashers Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-483 Commercial Coffee Brewers Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-415 Commercial Boilers Data Collection Form	Form and Instruction	Modified	Available
Form 5900-227 Clothes Washers Data Collection Form	Form and Instruction	Modified	Available
Form 5900-388 Clothes Dryers Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-38 Ceiling Fans Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-35 CAC-ASHP Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-37 Boilers Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-210 Audio Video Data Collection Form	Form and Instruction	Modified	Repair queued
Form 5900-210 Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Repair queued
2078ss08.docx	Supporting Statement A	Uploaded 2021-11-19	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
24770	Third Party Certified Product Information	Form and Instruction	Modified	Verification Testing Summary Report
24770	Third Party Certified Product Information	Form and Instruction	Modified	Ineligible Product Form
24770	Third Party Certified Product Information	Form and Instruction	Modified	Failure Report
24770	Third Party Certified Product Information	Form and Instruction	Modified
236924	Most Efficient	Form and Instruction	Modified	Windows Application
236924	Most Efficient	Form and Instruction	Modified	Most Efficient HVAC Application
236924	Most Efficient	Form and Instruction	Modified
236923	Partner Response Forms (PRFs)	Form and Instruction	Modified	Partner Response Form Non-Disputable
236923	Partner Response Forms (PRFs)	Form and Instruction	Modified	Partner Response Form Lighting
236923	Partner Response Forms (PRFs)	Form and Instruction	Modified	Partner Response Form Disputable
236923	Partner Response Forms (PRFs)	Form and Instruction	Modified	Partner Response Form Certification Errors
236923	Partner Response Forms (PRFs)	Form and Instruction	Modified
196468	Application for AB, CB, Lab, and W/SMTL Recognition and Scope Expansion	Form and Instruction	Modified	WMTLs SMTLs Data Entry
196468	Application for AB, CB, Lab, and W/SMTL Recognition and Scope Expansion	Form and Instruction	Modified	Application Certification Body
196468	Application for AB, CB, Lab, and W/SMTL Recognition and Scope Expansion	Form and Instruction	Modified	Application Accredited Laboratory
196468	Application for AB, CB, Lab, and W/SMTL Recognition and Scope Expansion	Form and Instruction	Modified	Application Accreditation Body
196468	Application for AB, CB, Lab, and W/SMTL Recognition and Scope Expansion	Form and Instruction	Modified
196467	Partnership Applications	Form and Instruction	Modified	Participation Form Brand Owner
196467	Partnership Applications	Form and Instruction	Modified	Participation Form EEPS
196467	Partnership Applications	Form and Instruction	Modified	Partnership Agreement
196467	Partnership Applications	Form and Instruction	Modified	Retailers Participation Form
196467	Partnership Applications	Form and Instruction	Modified
196466	Partner of the Year Award Applicaiton	Form and Instruction	Modified	Part 2 Product Brand Owner
196466	Partner of the Year Award Applicaiton	Form and Instruction	Modified	App Retailer
196466	Partner of the Year Award Applicaiton	Form and Instruction	Modified	Product Brand Owner
196466	Partner of the Year Award Applicaiton	Form and Instruction	Modified	ES Marketing
196466	Partner of the Year Award Applicaiton	Form and Instruction	Modified	Energy Efficiency Program Delivery
196466	Partner of the Year Award Applicaiton	Form and Instruction	Modified	Instruction - Executive Summary
196466	Partner of the Year Award Applicaiton	Form and Instruction	Modified
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Water Heaters Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Water Coolers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Ventilating Fans Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Vending Machines Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Uninterruptible Power Supply Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Televisions Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Telephony Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Set Top Boxes Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Room Air Conditioners Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Room Air Cleaners Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Refrigerators and Freezers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Pool Pumps Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Luminaires Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Light Commercial HVAC Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Lamps Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Laboratory Grade Refrigerators and Freezers Data Collection
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Imaging Equipment Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Geothermal Heat Pumps Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Furnaces Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Electric Vehicle Supply Equipment Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Displays Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Dishwashers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Dehumidifiers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Decorative Light Strings Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Data Center Storage Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Connected Thermostats Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Computers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Computer Servers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Commercial Water Heaters Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Commercial Steam Cookers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Commercial Refrigerators and Freezers Data Collection
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Commercial Ovens Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Commercial Ice Machines Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Commercial Hot Food Holding Cabinets Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Commercial Griddles Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Commercial Fryers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Commercial Dishwashers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Commercial Coffee Brewers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Commercial Boilers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Clothes Washers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Clothes Dryers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Ceiling Fans Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	CAC-ASHP Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Boilers Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified	Audio Video Data Collection Form
196465	Unit Shipment Data for ENERGY STAR Product Labeling	Form and Instruction	Modified

ICR Details

OMB Control No: 2060-0528	ICR Reference No: 202111-2060-004
Status: Active	Previous ICR Reference No: 201907-2060-009
Agency/Subagency: EPA/OAR	Agency Tracking No: 2078.08
Title: EPA's ENERGY STAR Product Labeling (Renewal)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/03/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/24/2021
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2025	36 Months From Approved	11/30/2022
Responses	2,732	0	2,732
Time Burden (Hours)	40,391	0	40,391
Cost Burden (Dollars)	0	0	0

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Abstract: ENERGY STAR is a voluntary program developed in collaboration with industry to create a self-sustaining market for energy efficient products. The center piece of the program is the ENERGY STAR label, a registered certification label that helps consumers identify products that save energy, save money, and help protect the environment without sacrificing quality or performance. In order to protect the integrity of the label and enhance its effectiveness in the marketplace, EPA must ensure that products carrying the label meet program requirements.

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Authorizing Statute(s): US Code: 42 USC 6294a. Name of Law: Energy Policy Act
   US Code: 42 USC 7403g. Name of Law: Clean Air Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 28339	05/26/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 66299	11/22/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Application for AB, CB, Lab, and W/SMTL Recognition and Scope Expansion	5900-217, 5900-218, 5900-255, 5900-216	Application Accreditation Body ,   Application Accredited Laboratory ,   Application Certification Body ,   WMTLs SMTLs Data Entry
Most Efficient	5900-439, 5900-440	Most Efficient HVAC Application ,   Windows Application
Partner Response Forms (PRFs)	5900-254, 5900-254, 5900-254, 5900-254	Partner Response Form Certification Errors ,   Partner Response Form Disputable ,   Partner Response Form Lighting ,   Partner Response Form Non-Disputable
Partner of the Year Award Applicaiton	5900-34, 5900-34, 5900-34, 5900-34, 5900-34, 5900-34	Instruction - Executive Summary ,   Energy Efficiency Program Delivery ,   ES Marketing ,   Product Brand Owner ,   App Retailer ,   Part 2 Product Brand Owner
Partnership Applications	5900-35, 5900-34, 5900-33, 5900-33	Retailers Participation Form ,   Partnership Agreement ,   Participation Form EEPS ,   Participation Form Brand Owner
Third Party Certified Product Information	5900-252, 5900-253, 5900-251	Failure Report ,   Ineligible Product Form ,   Verification Testing Summary Report
Unit Shipment Data for ENERGY STAR Product Labeling	5900-210, 5900-37, 5900-35, 5900-38, 5900-388, 5900-227, 5900-415, 5900-483, 5900-164, 5900-42, 5900-208, 5900-41, 5900-168, 5900-39, 5900-44, 5900-351, 5900-51, 5900-28, 5900-165, 5900-165, 5900-416, 5900-350, 5900-166, 5900-43, 5900-163, 5900-224, 5900438, 5900-49, 5900-417, 5900-229, 5900-50, 5900-235, 5900-348, 5900-230, 5900-35, 5900-234, 5900-206, 5900-54, 5900-55, 5900-47, 5900-56, 5900-57, 5900-58, 5900-228, 5900-48	Audio Video Data Collection Form ,   Boilers Data Collection Form ,   CAC-ASHP Data Collection Form ,   Ceiling Fans Data Collection Form ,   Clothes Dryers Data Collection Form ,   Clothes Washers Data Collection Form ,   Commercial Boilers Data Collection Form ,   Commercial Coffee Brewers Data Collection Form ,   Commercial Dishwashers Data Collection Form ,   Commercial Fryers Data Collection Form ,   Commercial Griddles Data Collection Form ,   Commercial Hot Food Holding Cabinets Data Collection Form ,   Commercial Ice Machines Data Collection Form ,   Commercial Ovens Data Collection Form ,   Commercial Refrigerators and Freezers Data Collection ,   Commercial Steam Cookers Data Collection Form ,   Commercial Water Heaters Data Collection Form ,   Computer Servers Data Collection Form ,   Computers Data Collection Form ,   Connected Thermostats Data Collection Form ,   Data Center Storage Data Collection Form ,   Decorative Light Strings Data Collection Form ,   Dehumidifiers Data Collection Form ,   Dishwashers Data Collection Form ,   Displays Data Collection Form ,   Electric Vehicle Supply Equipment Data Collection Form ,   Furnaces Data Collection Form ,   Geothermal Heat Pumps Data Collection Form ,   Imaging Equipment Data Collection Form ,   Laboratory Grade Refrigerators and Freezers Data Collection ,   Lamps Data Collection Form ,   Light Commercial HVAC Data Collection Form ,   Luminaires Data Collection Form ,   Pool Pumps Data Collection Form ,   Refrigerators and Freezers Data Collection Form ,   Room Air Cleaners Data Collection Form ,   Room Air Conditioners Data Collection Form ,   Set Top Boxes Data Collection Form ,   Telephony Data Collection Form ,   Televisions Data Collection Form ,   Uninterruptible Power Supply Data Collection Form ,   Vending Machines Data Collection Form ,   Ventilating Fans Data Collection Form ,   Water Coolers Data Collection Form ,   Water Heaters Data Collection Form

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,732	2,732	0	0	0	0
Annual Time Burden (Hours)	40,391	40,391	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $506,774

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/24/2021

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