5900-206 Set Top Boxes Data Collection Form

Expiration Date: 1/31/2022
United States
ENVIRONMENTAL PROTECTION AGENCY
Washington, D.C. 20460
ENERGY STAR Set Top Boxes Partner Unit Shipment Data for Calendar Year 2020
Office of Atmospheric Programs
This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0528). Responses to this collection of information are voluntary (Section103(g) of the Clean Air Act). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The public reporting and recordkeeping burden for this collection of information is estimated to be 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 to the Regulatory Support Division Director, U.S. Environmental Protection Agency (2821T), 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.					← Partner Name incomplete
PARTNER NAME (Per your Partnership Agreement):
					← Submitted By incomplete
SUBMITTED BY (Your name):
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.					← Check box indicating zero shipments OR report shipments
If you shipped zero ENERGY STAR certified models to or within the U.S. in 2020, please check here and leave the table below blank.
		0
Reporting Period: CALENDAR YEAR 2020 (JAN. 1 TO DEC. 31)
Set-top Box Base Type	ENERGY STAR U.S. Unit Shipments1
Cable
Satellite
Cable DTA
Multichannel Video Programming Distributor (MVPD) Internet Protocol (IP)
Over-the-top IP
Thin Client/Remote
Total Boxes	-
1 Manufacturing Partners can sell or distribute ENERGY STAR certified and labeled units to non-ENERGY STAR Service Provider Partners if they continue to meet ENERGY STAR eligibility criteria in all possible hardware and software configurations.
Submission Deadline: March 1, 2021
Please submit by mail or email to:	Or	To CTA:
Katie Veasey		Brian Comiskey
ICF		[email protected]
2550 S Clark St
Suite 1200
Arlington, VA 22202
[email protected]
Do not submit form to both CTA and ICF
For additional protection of confidential business information, partners may elect to submit the above information to a third party for aggregation prior to submission to EPA. If this path is chosen, the third party must submit to EPA the above table of information containing the summary data received from partners and a list of partners that contributed to the data collection effort.
Any information submitted to EPA for which a claim of confidentiality is made will be safeguarded according to the Agency's policies set forth in Title 40, chapter 1, part 1, subpart B - Confidentiality of Business Information (see 40 CFR part 2; 41 FR 36902, September 1, 1976; amended by 43 FR 40000, September 8, 1978; 43 FR 42251, September 20, 1978; 44 FR 17674, March 23, 1979).
EPA Form No. 5900-206 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.