EIA-861S Annual Electric Power Industry Report

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Overview

contact info (2)
Short form schedules

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Sheet 1: contact info (2)

				Form EIA-861S					Due Date: 2013
				ANNUAL ELECTRIC POWER INDUSTRY REPORT					Form Approval: OMB No. 1905-0129
				(Short Form)					Approval Expires: 10/31/2013
									Burden hours: 0.75
NOTICE: This report is mandatory under the Federal Energy Administration Act of 1974 (Public Law 93-275). 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
Contact Information
First Name:						Last Name:
Title:
Telephone:						FAX:
Email:
Supervisor Information
First Name:						Last Name:
Title:
Telephone:						FAX:
Email:
Entity and Preparer Information
Legal Name of Entity:
Current Address of Entity's Principal Business Office:
Preparer's Legal Name (If Different From Entity's Legal Name):
Current Address of Preparer's Office (If Different From Current Address of Entity's Principal Business Office):
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, preferably by email at EIA-861@eia.gov.
	Jorge Luna-Camara						Stephen Scott
	Phone: (202) 586-3945						Phone: (202) 586-5140
					FAX Number: (202) 287-1938

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Sheet 2: Short form schedules

			Form EIA-861S			Due Date:	2013
			ANNUAL ELECTRIC POWER INDUSTRY REPORT			Form Approval:	OMB No. 1905-0129
			(Short Form)			Approval Expires:	10/31/2013
						Burden hours:	0.75 Hours
Entity Name:		ABC Company
Entity ID:		0000000				Data Year:	2012
SCHEDULE 2. PART C. GREEN PRICING
Green Pricing programs are voluntary retail programs where customers pay an extra fee to purchase electricity generated from renewable sources. DO NOT include RPS here.
	Did you have voluntary Retail Green Pricing Programs during the reporting year?					[ ] YES	[ ] NO
SCHEDULE 2. PART D. NET METERING
Net Metering programs allow customers to sell excess power they generate back to the electrical grid to offset consumption. For net metering applications of 2 MW nameplate capacity and less, provide the information about programs.
	Did you have Net Metering Programs during the reporting year?					[ ] YES	[ ] NO
Schedule 4. Part A Sales to Ultimate Customers. Full Service-Energy and Delivery Service (Bundled)
	Provide total Revenue in thousand of dollars, megawatt hours of Retail Sales, and customer counts by state.		State	Revenue (1000$)	Retail Sales (Mwh)	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. Part A. Demand-Side Management Information
	Did you have company-administered Demand-Side Management programs during the reporting year?					[ ] YES	[ ] NO
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	[ ] NO
	If yes provide:
STATE			Residential (a)	Commercial (b)	Industrial (c)	Transportation (d)	Total (e)
1	Number of Customers						0.000
Schedule 6. Part D. Advanced Metering
AMR- data transmitted one-way, from customer to utility. AMI- data can be transmitted in both directions, between the delivery entity and the customer.
	Did you operate any AMR during the reporting year?					[ ] YES	[ ] NO
	If yes provide:
STATE			Residential (a)	Commercial (b)	Industrial (c)	Transportation (d)	Total (e)
1	Number of AMR Meters						0
	Did you operate any AMI during the reporting year?					[ ] YES	[ ] NO
	If yes provide:
2	Number of AMI Meters						0
3	Energy Served Through AMI						0