ENERGY STAR Program in the Commercial and Industrial Sectors - Public Sector Entities

EPA's ENERGY STAR Program in the Commercial and Industrial Sectors (Renewal)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2060-0347 can be found here:

Documents and Forms

Document Name Document Type
Form 5900-20 ENERGY STAR Program in the Commercial and Industrial Sectors - Public Sector Entities Form
5900-20 ENERGY STAR Leaders - Leaders Story Leaders Story.doc www.energystar.gov/istar/pmpam Form
5900-20 ENERGY STAR Leaders - Eligible Facilities List Leaders Eligible Facilities.doc www.energystar.gov/istar/pmpam Form
5900-20 ENERGY STAR Leaders - Ineligible Facilities List Leaders Ineligible Facilities.doc www.energystar.gov/istar/pmpam Form
5900-20 Leaders - Facilitiy Summary Report Leaders Facility Summary Report.doc www.energystar.gov/istar/pmpam Form
5900-22 Statement of Energy Design Intent Statement of Energy Design Intent.docx www.energystar.gov/ia/business/tools_resources/target_finder/help/Statement_of_Energy_Design_Intent.htm Form
5900-197 Data Checklist Data Checklist.pdf www.energystar.gov Form
5900-33 EEPS Partnership Agreement EEPS_Partnership_Agreement.docx www.energystar.gov/ia/about/join/EEPS_Partnership_Agreement.pdf?0c90-dd4a Form and Instruction
5900-19 Attachment to C&I Partnership Letter C&I Partnership_Letter.doc www.energystar.gov/index.cfm?fuseaction=opa.showPartnershipApplicationChecklist&p_code=ESB&associations=false&newAgreeme Form

Information Collection (IC) Details

IC Title:	ENERGY STAR Program in the Commercial and Industrial Sectors - Public Sector Entities	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5900-20	ENERGY STAR Leaders - Leaders Story	Leaders Story.doc	https://www.energystar.gov/istar/pmpam	Yes	Yes	Fillable Printable
Form	5900-20	ENERGY STAR Leaders - Eligible Facilities List	Leaders Eligible Facilities.doc	https://www.energystar.gov/istar/pmpam	Yes	Yes	Fillable Printable
Form	5900-20	ENERGY STAR Leaders - Ineligible Facilities List	Leaders Ineligible Facilities.doc	https://www.energystar.gov/istar/pmpam	Yes	Yes	Fillable Printable
Form	5900-20	Leaders - Facilitiy Summary Report	Leaders Facility Summary Report.doc	https://www.energystar.gov/istar/pmpam	Yes	Yes	Fillable Printable
Form	5900-22	Statement of Energy Design Intent	Statement of Energy Design Intent.docx	http://www.energystar.gov/ia/business/tools_resources/target_finder/help/Statement_of_Energy_Design_Intent.htm	Yes	No	Fillable Printable
Form	5900-197	Data Checklist	Data Checklist.pdf	www.energystar.gov	Yes	Yes	Fillable Printable
Form and Instruction	5900-33	EEPS Partnership Agreement	EEPS_Partnership_Agreement.docx	http://www.energystar.gov/ia/about/join/EEPS_Partnership_Agreement.pdf?0c90-dd4a	Yes	Yes	Fillable Fileable
Form	5900-19	Attachment to C&I Partnership Letter	C&I Partnership_Letter.doc	https://www.energystar.gov/index.cfm?fuseaction=opa.showPartnershipApplicationChecklist&p_code=ESB&associations=false&newAgreement=true	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: 5,336	Number of Respondents for Small Entity: 150

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	83,632	-169	66,742	17,059
Annual IC Time Burden (Hours)	72,967	-66	26,057	46,976
Annual IC Cost Burden (Dollars)	2,570,100	2,100	1,084,680	1,483,320

Documents for IC

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.