Form EIA-861S ANNUAL ELECTRIC POWER INDUSTRY REPORT (Short Form)

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Overview

contact info
Short form schedules

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Sheet 1: contact info

					Form EIA-861S				Due Date:
					ANNUAL ELECTRIC POWER INDUSTRY REPORT				Form Approval: OMB No. 1905-0129
					(Short Form)				Approval Expires: xx/xx/xxxx
									Burden hours: 0.75
NOTICE: This report is mandatory under 15 U.S.C. §772(b). Failure to comply may result in criminal fines, civil penalties and other sanctions as provided by law. For further information concerning sanctions and data protections see the provisions on sanctions and the provisions concerning the confidentiality of information in the instructions. Title 18 U.S.C. §1001 makes it a criminal offense for any person knowingly and willingly to make to any Agency or Department of the United States any false, fictitious, or fraudulent statements as to any matter within its jurisdiction. Entities that report using the Form EIA-861 do not complete the Form EIA-861S. For information on which entities are required to file the Form EIA-861 or EIA-861S survey forms, see the instructions for Form EIA-861S.
Entity Name:
Entity ID:
SCHEDULE 1. IDENTIFICATION
Who is the survey contact? -Contact EIA by email at EIA-861@eia.gov to correct or update this information
First Name:						Last Name:
Title:		Prefilled
Telephone:						FAX:
Email:
Who is the survey contact's supervisor? -Contact EIA by email at EIA-861@eia.gov to correct or update this information
First Name:						Last Name:
Title:
Telephone:						FAX:
Email:
Entity and Preparer Information
What is the legal name of the entity that this form is being prepared for?
What is the current address for this entity's principal business office?
• Enter the complete address, excluding the legal name, of the entity’s principal business office
What is the preparer's legal name? • Enter the legal name of the company which prepares this form, if different from the entity's legal name
What is the preparer's current address? • Enter the address that this form should be mailed to, if it is different from the entity's principal business office.
Select respondent type (check one)
	Federal					State
	Political Subdivision					Municipal
	Municipal Marketing Authority					Investor-Owned
	Cooperative
For questions or additional information about the Form EIA-861S, contact the Survey Managers by email at EIA-861@eia.gov.
					Stephen Scott
					Phone: (202) 586-5140
					FAX Number: (202) 287-1938

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Sheet 2: Short form schedules

			Form EIA-861S			Due Date:
			ANNUAL ELECTRIC POWER INDUSTRY REPORT			Form Approval:	OMB No. 1905-0129
			(Short Form)			Approval Expires:	xx/xx/xxxx
						Burden hours:	0.75
Entity Name:
Entity ID:						Data Year:
Schedule 4. Part A Sales to Ultimate Customers. Full Service-Energy and Delivery Service (Bundled)
• Report Total Revenue in thousands of dollars • Report Total Retail Sales in Megawatt hours • Report Total customer counts
State		Balancing Authority
Total Revenue
Total Retail Sales
Total Number of Customers
Schedule 5. Merger and Acquisitions
Was your entity a part of a merger or acquisition during the reporting year?
		Yes
		No
Schedule 6. Parts A&B. Demand-Side Management Information
Did you have company-administered Demand-Side Management programs during the reporting year?
		Yes
		No
If you have a demand side management (DSM) program for grid-enabled water heaters (as defined by DOE's EERE), how many grid-enabled water heaters were added to your program this year?
		Number of heaters
Schedule 6. Part C. Time-Based Rate Programs (Dynamic Pricing Programs)
Time-based rate programs include real-time pricing, critical peak pricing, variable peak pricing and time-of-use rates, also known as dynamic pricing programs.
Did you operate any time-based rate programs which are administered through a tariff during the reporting year?
		Yes - Enter number of customers by state and balancing authority
		No
STATE		Balancing Authority
		Residential (a)	Commercial (b)	Industrial (c)	Transportation (d)	Total (e)
1	Number of Customers	0	0	0	0	0.000
Schedule 6. Part D. Advanced Metering
Automated Meter Reading (AMR)- data transmitted one-way, from customer to utility.
	Did you operate any AMR during the reporting year?
		Yes - Enter number of AMR meters by sector below.
		No
STATE		Balancing Authority
		Residential (a)	Commercial (b)	Industrial (c)	Transportation (d)	Total (e)
1	Number of AMR Meters					0
Advanced Metering Infrastructure (AMI)- data can be transmitted in both directions, between the delivery entity and the customer.
	Did you operate any AMI during the reporting year?
		Yes
		No
STATE		Balancing Authority
			Residential (a)	Commercial (b)	Industrial (c)	Transportation (d)	Total (e)
2	Number of AMI Meters						0
3	Energy Served Through AMI
SCHEDULE 7. PART A. NET METERING
Net Metering programs allow customers to sell excess power they generate back to the electrical grid to offset consumption.
	Did you have Net Metering Programs during the reporting year?
		Yes		No