Form 5900-574 Update My Information for LMOP Partners

Update My Information for LMOP Partners
(Web Form)

Please use the form below to provide updates to LMOP regarding any of your information as a Partner.
Revisions will be reflected in the next update of Partner information on the LMOP website.
This collection of information is approved by OMB under the
Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No.
2060-0446). Responses to this collection of information are voluntary
(42 USC 7403(g)). An agency may not conduct or sponsor, and a person
is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. The public reporting
and recordkeeping burden for this collection of information is
estimated to be 0.75 to 2.5 hours per response. Send comments on the
Agency’s need for this information, the accuracy of the provided
burden estimates and any suggested methods for minimizing
respondent burden to the Regulatory Support Division Director, U.S.
Environmental Protection Agency (2821T), 1200 Pennsylvania Ave.,
NW, Washington, D.C. 20460. Include the OMB control number in any
correspondence. Do not send the completed form to this address.
[Web form follows. Form contents described below]
Field Name

Data Type

Required

Name

Single Line of Text

Yes

Email Address
Organization Name
Website Address
Street
City
State
Zip
Energy Partner Type
Industry Partner Type

Single Line of Text
Single Line of Text
Single Line of Text

Description

Multiple Lines of Text

Yes
Yes
No
No
No
No
No
No
No
No

Revise or Replace Org
Description
Expertise: Professional
Services
Expertise: Equipment
Supplier Type
New Primary Contact?

Single Line of Text
Single Line of Text
Single Line of Text
Dropdown options
Dropdown options

Replace/Revise
Multiselect
Multiselect
Yes/No

No
No
No
Yes

Notes
Name of organization point of
contact
Email address of point of contact
Partner organization name
URL
Partner organization address
Partner organization address
Partner organization address
Partner organization address
Specify type of Partner
Specify type of Partner
A brief description (150 words or
less) of Partner organization

Specify Partner’s area of expertise
Specify Partner’s area of expertise
Is this a different primary contact
than currently listed on the website

New Organization
Address?

Yes/No

Additional Contacts

Multiple Lines of Text

Other Edits

Multiple Lines of Text

EPA Form Number 5900-574

Yes
No

No

Is the primary contact's address the
same as the organization's address
Edits to names, titles, email
addresses, or phone numbers of
existing contacts or to add new
contacts
Indicate other edits for your
organization as a Partner that are
not addressed above