Information Collection

Energy Right Program

IC 35855 under ICR 202208-3316-001 · OMB 3316-0019.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TVA 17658 Energy Right Program	Form
Form 17655 Agreement to Participate Homeowner Energy Right Program	Form and Instruction
Form 17656 Agreement to Participate Landlord Energy Right Program	Form and Instruction
Form 17657 Repayment Agreement Energy Right Program	Form and Instruction
Form 17658 Security Agreement Energy Right Program	Form and Instruction
Form 17659 Notice of Right to Cancel Energy Right Program	Form and Instruction
TVA 17658 Security Agreement 17658.docx	Form
TVA 17659 Notice of Right to Cancel 17659.docx	Form
TVA 17657 Repayment Agreement 17657.docx	Form
TVA 17656 Agreement to Participate - Landlord 17656.docx	Form
TVA 17655 Agreement to Participate - Homeowner 17655.docx	Form
17655 Agreement to Participate Homeowner ER Agreement to Participate - Homeowner 17655.pdf	Form and Instruction
17656 Agreement to Participate Landlord ER Agreement to Participate - Landlord 17656.pdf	Form and Instruction
17657 Repayment Agreement ER Repayment Agreement 17657.pdf	Form and Instruction
17658 Security Agreement ER Security Agreement 17658.pdf	Form and Instruction
17659 Notice of Right to Cancel ER Notice of Right to Cancel 17659.pdf	Form and Instruction
SORN for EnergyRight.pdf Privacy Act System of Records Notice	IC Document
SORN for EnergyRight.pdf Privacy Act System of Records Notice	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	17655	Yes	Yes	Fillable Fileable Signable
Form and Instruction	17656	Yes	Yes	Fillable Fileable Signable
Form and Instruction	17657	Yes	Yes	Fillable Fileable Signable
Form and Instruction	17658	Yes	Yes	Fillable Fileable Signable
Form and Instruction	17659	Yes	Yes	Fillable Fileable Signable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title: TVA-29, Energy Program Participant Records

FR Citation: 80 FR 24030

Number of Respondents: 33,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	33,500	500	33,000
Annual IC Time Burden (Hours)	8,650	-1,370	10,020
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Privacy Act System of Records Notice		04/12/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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