Information Collection

Energy Star Program in the Residential Sector: States and Locals

IC 191109 under ICR 202401-2060-010 · OMB 2060-0586.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5900-421 Quarterly Report Energy Star Program in the Residential Sector: States and Locals	Form and Instruction
5900-421 Quarterly Report 5900-421 Quarterly Report 5900-421 .docx www.energystar.gov/index.cfm?fuseaction=host.loginform	Form and Instruction

IC Title:

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	5900-421			https://www.energystar.gov/index.cfm?fuseaction=host.loginform	Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8

Number of Respondents for Small Entity: 2

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

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	25	1	2	22
Annual IC Time Burden (Hours)	65	4	5	56
Annual IC Cost Burden (Dollars)	0	0	0	0

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.

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