QUALIFIED PRODUCT FORM

   FOR

  COMPUTERS

ENERGY STAR^® Product Information Form for Use by ENERGY STAR Labeled Computer Partners

(Companies who have joined ENERGY STAR for Computers by signing the Memorandum of Understanding)

You may use this form to report only those products that are sold under your company’s brand name.  If your firm sells its models to another company that uses its own brand name, that company must join the program and report its own products.  Information from this form will be added to the list of Energy Star qualified computer products. Please copy this form and fax one for each qualifying product model to Energy Star, Environment and Development Foundation, 886-3-5820231.

Company Name:__________________________________

    (As listed in MOU)
  Product Contact Information

(For public requesting product information)

Tel:________________  Fax:_____________________

E-mail: _______________________________________

Note: Please provide the following information on the configuration of the tested model ONLY.

Mark below how is this product marketed to consumers?

Personal Computer  _______ Workstation _______        Integrated Computer System  _______           X-Terminal  ______

Please complete all the fields below.

Tested By: (Name of Independent Testing Firm or Self-Tested)  _____________________ Date Tested: _______________

Qualification on network(s)

Does this model ship with a network interface?(e.g., card or embedded on the motherboard)    Yes _______        No _____

Network Interface Details: ________________________________________________________

Does this model meet all the requirements of the Energy Star Computer MOU Version 3.0, including the sleep mode requirements when on a network. (See Section IV.D.1 of the Energy Star Computer MOU Version 3.0)        Yes         _______          No     ________

Please describe how this product meets the network requirements of the new MOU ___________________________________________

If the model does NOT meet the network requirements, please explain: _____________________________________________________

How does this product control the power management of a monitor? ______________________________________________________

This computer is a Desktop/Deskside  _______           Laptop ________     Other _________