OMB Control No. 2060-0528
                                                     Approval expires 03/31/2011
                                   United States
                     ENVIRONMENTAL PROTECTION AGENCY
                                Washington, D.C. 20460
                           ENERGY STAR Imaging Equipment Partner
                                  Unit Shipment Data
                              Office of Atmospheric Programs
         NAME OF MANUFACTURER:
         DATE OF SUBMISSION:
         SUBMITTED BY (NAME):
         PLEASE LIST ANY UNAFFILIATED 
         PRIVATE LABELERS THAT 
         REBRAND YOUR PRODUCTS: 
         Below, only report shipments to consumers or retailers.  Do not include business to 
         business shipments (shipments to unaffiliated private labelers).  If you ONLY ship to 
         private labelers, indicate zero shipments and list private labelers selling in the U.S. 
         marketplace on the line above.
         Reporting Period: CALENDAR YEAR 2009 (JAN. TO DEC.)
                                       ENERGY STAR® U.S. 
                                        Unit Shipments to 
                                         Consumers or 
                                          Retailers 
          Imaging Equipment Product Type (REQUIRED)
         Copiers Total
          Qualified by OM
           Large Format (Color DS, Color TT, DT, Mono DS, Mono 
           EP, Mono TT, Color EP, SI)
          Qualified by TEC
           Mono Standard Format Total (Thermal, Dye sub, EP)
             ≤ 15 IPM
             16 - 39 IPM
             40 - 82 IPM
             ≥ 83 IPM
           Color Standard Format Total (Thermal, Dye sub, EP, 
           solid ink)
             ≤ 32 IPM
             33 - 58 IPM
             ≥ 59 IPM
         Digital Duplicators Total
           Mono Standard Format Total
             ≤ 15 IPM
             16 - 39 IPM
             40 - 82 IPM
             ≥ 83 IPM
           Color Standard Format Total
             ≤ 32 IPM
      EPA Form No. 5900-163
                                            OMB Control No. 2060-0528
                                                Approval expires 03/31/2011
            33 - 58 IPM
            ≥ 59 IPM
        Fax Machines Total
         Qualified by OM
          Ink Jet Standard Format (Color or Mono)
         Qualified by TEC
          Mono Standard Format Total (Thermal, Dye sub, EP)
            ≤ 15 IPM
            16 - 39 IPM
            40 - 82 IPM
            ≥ 83 IPM
          Color Standard Format Total (Thermal, EP, solid ink)
            ≤ 32 IPM
            33 - 58 IPM
            ≥ 59 IPM
        Mailing Machines Total
        Multifunction Devices (MFDs) Total
         Qualified by OM
          Ink Jet Standard Format (Color or Mono)
          Ink Jet Large Format (Color or Mono)
          Non-Ink-Jet Large Format (Color DS, Color TT, DT, 
          Mono DS, Mono EP, Mono TT, Color EP, SI)
         Qualified by TEC
          Mono Standard Format Total (High Performance Ink 
          Jet, Thermal, Dye sub, EP)
            ≤ 9 IPM
            10 - 26 IPM
            27 - 68 IPM
            ≥ 69 IPM
          Color Standard Format Total (High Performance Ink 
          Jet, Thermal, Dye sub, EP, solid ink)
            ≤ 26 IPM
            27 - 62 IPM
            ≥ 63 IPM
        Printers Total
         Qualified by OM
          Impact Standard Format (Color Impact, Mono Impact )
          Ink Jet Standard Format (Color or Mono)
          Ink Jet Large Format (Color or Mono)
          Small Format (Color DS, DT, Color IJ, Color Impact, 
          Color TT, Mono DS, Mono EP, Mono IJ, Mono Impact, 
          Mono TT, Color EP, SI)
          Non-Ink-Jet Large Format (Color DS, Color Impact, 
          Color TT, DT, Mono DS, Mono EP, Mono Impact, Mono 
          TT, Color EP, SI)
         Qualified by TEC
          Mono Standard Format Total (High Performance Ink 
          Jet, Thermal, Dye sub, EP)
            ≤ 15 IPM
            16 - 39 IPM
            40 - 82 IPM
            ≥ 83 IPM
          Color Standard Format Total (High Performance Ink 
          Jet, Thermal, Dye sub, EP, solid ink)
            ≤ 32 IPM
      EPA Form No. 5900-163
                                                                                              OMB Control No. 2060-0528
                                                                                                Approval expires 03/31/2011
                         33 - 58 IPM
                         ≥ 59 IPM
                 Scanners Total
                 Total                                                                          0
                 Submission Deadline: February 26, 2010
                 Deadline to Avoid Partnership Termination: March 31, 2010
                 *Do not provide duplicate data to both ITI and ICF
                 ITI has agreed to aggregate data for all Imaging          Please submit by mail or email to:
                 Equipment Partners.                                       Joshua Forgotson
                 Please submit by email or fax to:                         ICF International
                 Ken Salaets                                               1725 Eye Street, NW
                 ksalaets@itic.org                                         Suite 1000
                 Fax: (202) 638-4922                                       Washington, DC 20006
                                                                           unitshipmentdata@icfi.com
                 EPA plans to use the data only for program evaluations.  EPA will release this information only as aggregated data and only to the 
                 extent required by law.
                 The public reporting and recordkeeping burden for this collection of information is estimated to average 6.69 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, including through the use of automated collection techniques to the Director, Collection Strategies 
                 Division, U.S. Environmental Protection Agency (2822T), 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.
            EPA Form No. 5900-163
                                            OMB Control No. 2060-0528
                                                Approval expires 03/31/2011
     United States
ENVIRONMENTAL PROTECTION AGENCY
  Washington, D.C. 20460
ENERGY STAR Imaging Equipment Partner
   Unit Shipment Data
Office of Atmospheric Programs
      EPA Form No. 5900-163