Application Form - Computers

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EPA CB
ID No.

1105295


ENERGY STAR
®


Application

Form

-

Computers


Form

Number:


FORM ES
-
09


Revision:


A


Page
1

of
3


5015

B.U. Bowman Drive
,

Bufo
rd, GA 30518 USA

Voice: 770
-
831
-
8048 Fax:

770
-
831
-
8598



Return one signed and dated, completed form along with packaging
and nameplate
artwork
, test reports and photographs

for each
product

submitted.

Section 1:
Applicant
Information

(the
manufacturer
, as listed on the
ENERGY STAR® partner list
)

Applicant’s complete, legal business name:







Address Line 1:







Address Line 2:







City:







State:







Country:







Zip/Postal Code:







Applicant Contact Name:







Title:







Phone #:







Fax #:







Email:







Website:






Section
2
: Product Information


Brand Name
:

Model

Name
:

Model Number
:

Product Description:

























Initial Date of MFG
:

Date Available On Market:

Is “Applicant” the OEM?

If no, list OEM














Yes

No

OEM
:






Sales
Channels:

Is product displayed on the web?



Yes

No

Is product sold through Enterprise
c
hannels?


Yes

No

Market:


(check
all that apply
)


United States

Canada

European Union

Australia/New Zealand


Taiwan

Japan

Switzerland

Other:






Product Type:

(check
one
)


Desktop



Integrated
Desktop


Workstation

Notebook

Tablet


Thin Client

S
mall
-
scale Server

Network Options:


(check
all that apply
)


802.11a/b


10/100 Ethernet


802.11g


Gig Ethernet



802.11n


Integrated NIC



Bluetooth


Discrete NIC

Will the Speed of Any Active 1 Gb/s or Higher Ethernet Network Links be Reduced to Less Than 1
Gb/s When Transitioning to Sleep or Off Mode?



Yes

No

O
perating System:

Name:








Version:






Processor:

Brand:








Name:







Speed per core:





GHz


Number of
physical
co
res:







Number of discrete processors:






Memory:

System memory:





GB Number of DIMMs:






Disk Storage:

Number of HDDs installed:






Total HDD capacity:





GB

Video Card (GPU)
:


Integrated GPU


Discrete GPU Brand:






Model:






Dedicated Non
-
Shared Memory:





MB Default Display Output Resolution
:






Frame buffer width:






Power Supply:

Is the product(s) powered by and shipped with an external power supply?

Yes

No

If Yes, list manufacturer and model:






Note that external power supplies (EPS) must meet
level V performance requirements under the
Interna
tional
Efficiency Marking Protocol and must include the level V marking.


EPA CB
ID No.

1105295


ENERGY STAR
®


Application

Form

-

Computers


Form

Number:


FORM ES
-
09


Revision:


A


Page
2

of
3


5015

B.U. Bowman Drive
,

Bufo
rd, GA 30518 USA

Voice: 770
-
831
-
8048 Fax:

770
-
831
-
8598



Workstations:

Is this product specifically marketed as a Workstation?


Yes

No

Does this product have a MTBF (hours) a
ge ≥ 15,000 hours?

(based on either Bellcore TR
-
NWT
-
000332, issue 6, 12/97 or field collected data)


Yes

No

Does the p
roduct
s
upport Erro
r
-
Correcting Code (ECC) and/or buffered
m
emory?


Yes

No

To qualify as a Workstation, all of the above must be Yes.

In addition, a Workstation must meet three or more of the following criteria (check all that apply):


P
rovide
s

supplemental power support for high
-
end graphics
(e.g., PCI
-
E 6
-
pin 12V
supplemental power feed)
;


W
ired for greater than x4 PCI
-
E on the motherboard in addition to the graphics slot(s) and/or
PCI
-
X support
;


Does not provide support for Uniform Memory Access (UMA) g
raphics;


Provides 5 or more PCI, PCI
-
E, or PCI
-
X slots;


Provides multi
-
processor support for 2 or more processors (shall support physically separate
processor packages/sockets, i.e., requirement cannot be met with
support for a single multi
-
core processor); and/or


Qualification by 2 or more Independent Software Vendor (ISV) product certifications; these
certifications can be in process, but shall be completed within 3 months of qualification.

Does the Workstation have multiple graphics devices?

Yes

No If Yes, how many?






Will the Workstation be qualified as a:

Workstation

Desktop

Small
-
scale S
ervers:

Is a display present?

Yes

No

Power Management:
(complete this section for the
as shipped

default configuration of the product(s) submitted)

Sleep Modes:

Sleep mode default time upon shipment:







minutes after user inactivity

Is the speed of active 1 Gb/s Ethernet link(s)
reduced when transitioning to Sleep or Off Mode?



Yes

No

Display sleep mode default time upon shipment:







minut
es after user inactivity

WOL Capability:

(check
all that apply
)

WOL from Sleep?

WOL from Off?

User c
an
e
nable and
d
isable WOL for
S
leep
m
ode?


Yes

No


Yes

No


Yes

No

Shipped with WOL enabled by default for
Sleep mode when operating on AC mains
power?

Yes

No

Provides users with the ability to enable WOL that is
accessible from both the cli
ent OS and over the
network?

Yes

No


WOL is automatically disabled when on battery power (notebooks / tablets only)

Wake Management:

Capable of both remote (via network) and
scheduled (via real
-
ti
me clock) wake events
from Sleep mode?

Yes

No

Provides clients with the ability to centrally manage
(via vendor tools) any wake management settings
that are configured through hardware settings, if the
manufacturer h
as control over such features?


Yes

No

Thin Clients:

Is the product capable of Sleep mode?

Yes

No

Are software u
pdates from the centrally managed network conducte
d while uni
t is in Sleep or Off
mode?


Yes

No


EPA CB
ID No.

1105295


ENERGY STAR
®


Application

Form

-

Computers


Form

Number:


FORM ES
-
09


Revision:


A


Page
3

of
3


5015

B.U. Bowman Drive
,

Bufo
rd, GA 30518 USA

Voice: 770
-
831
-
8048 Fax:

770
-
831
-
8598




Section 3
:
Family / Series Qualifications:

Tested Model

N
umber
:







Tested Model

Name:







Additional Models Represented:







Provide justification explaining how the model tested is representative of the product family. The representative model
submitted for test must be the model with the greatest energy consumption. Energy Star program requirements state the when
submitting p
roduct families, manufacturers continue to be held accountable for any efficiency claims made about their
products, including those not tested or for which data was not reported.



Justification may include power measurements made by the manufacturer on ad
ditional models, or sound engineering
rationale.

Product family / series justification:







Are there configurations within this product family that will not be ENERGY STAR® qualified?


Yes

No

If Yes,

please describe how the model numbering will differentiate between qualified and non
-
qualified models:







Section 4: Signature

(signature indicates that the information provided above is accurate for the model(s) submitted)
















Applicant Contact

Date