Information Collection

Public Sector

IC 45386 under ICR 202212-2060-019 · OMB 2060-0347.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5900-197 Public Sector	Form and Instruction
5900-197 ENERGY STAR Application for Certification 5900-197 ENERGY STAR Application for Certification.pdf	Form and Instruction
5900-382 ENERGY STAR Certification Audit Form 5900-382 ENERGY STAR Certification Audit Form.pdf	Form and Instruction
5900-19 Online Partnership Agreement Organizations that Own 5900-19 Online Partnership Agreement Organizations that Own Buildings & Plants.pdf	Form and Instruction
5900-436 Indoor Environmental Quality Measurement Form for E 5900-436 Indoor Environmental Quality Measurement Form for ENERGY STAR Building Verification Site Visit.pdf	Form and Instruction
5900-443 ENERGY STAR Partner of the Year Award Application f 5900-443 ENERGY STAR Partner of the Year Award Application - Sustained Excellence Energy Management.pdf	Form and Instruction
5900-444 ENERGY STAR Partner of the Year Award Application f 5900-444 ENERGY STAR Partner of the Year Award Application - Energy Management.pdf	Form and Instruction
5900-445 ENERGY START Partner of the Year Award Supplemental 5900-445 ENERGY STAR Partner of the Year Award Supplemental.pdf	Form and Instruction
5900-198 Statement of Energy Improvement 5900-198 Statement of Energy Improvement .pdf	Form and Instruction
5900-383 Professional Engineer Verification Checklist 5900-383 Professional Engineer Verification Checklist.pdf	Form and Instruction
5900-22 Statement of Energy Design Intent 5900-22 Statement of Energy Design Intent .pdf	Form and Instruction
5900-89 Statement of Energy Performance 5900-89 Statement of Energy Performance .pdf	Form and Instruction
5900-623 ENERGY STAR NextGen Application 5900-623 ENERGY STAR NextGen Application.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Public Sector

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	5900-197	ENERGY STAR Application for Certification	5900-197 ENERGY STAR Application for Certification.pdf	Yes	Yes	Fillable Printable
Form and Instruction	5900-382	ENERGY STAR Certification Audit Form	5900-382 ENERGY STAR Certification Audit Form.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	5900-19	Online Partnership Agreement Organizations that Own	5900-19 Online Partnership Agreement Organizations that Own Buildings & Plants.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	5900-436	Indoor Environmental Quality Measurement Form for E	5900-436 Indoor Environmental Quality Measurement Form for ENERGY STAR Building Verification Site Visit.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5900-443	ENERGY STAR Partner of the Year Award Application f	5900-443 ENERGY STAR Partner of the Year Award Application - Sustained Excellence Energy Management.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	5900-444	ENERGY STAR Partner of the Year Award Application f	5900-444 ENERGY STAR Partner of the Year Award Application - Energy Management.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	5900-445	ENERGY START Partner of the Year Award Supplemental	5900-445 ENERGY STAR Partner of the Year Award Supplemental.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	5900-198	Statement of Energy Improvement	5900-198 Statement of Energy ImprovementÂ .pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5900-383	Professional Engineer Verification Checklist	5900-383 Professional Engineer Verification Checklist.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5900-22	Statement of Energy Design Intent	5900-22 Statement of Energy Design IntentÂ .pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5900-89	Statement of Energy Performance	5900-89 Statement of Energy PerformanceÂ .pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	5900-623	ENERGY STAR NextGen Application	5900-623 ENERGY STAR NextGen Application.pdf	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 16,808

Number of Respondents for Small Entity: 1,180

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	151,147	2,006	17,548	131,593
Annual IC Time Burden (Hours)	71,950	125	-9,006	80,831
Annual IC Cost Burden (Dollars)	1,278,788	63,353	-1,865	1,217,300

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.