Appendix B to Subpart S to Part 431 - Certification Report for Metal Halide Lamp Ballasts

All information reported in this Certification Report(s) is true, accurate, and complete. The company is aware of the penalties associated with violations of the Act, the regulations thereunder, and is also aware of the provisions contained in 18 U.S.C. 1001, which prohibits knowingly making false statements to the Federal Government. Name of Company Official or Third-Party Representative: Signature of Company Official or Third-Party Representative: Title: Date: Equipment Type: Manufacturer: Name of Person to Contact for Further Information: Address: Telephone Number: Facsimile Number: E-mail: For Existing, New, or Modified Models: [Provide specific equipment information including, for each basic model, the product class, the manufacturer's model number(s), and the other information required in 431.327(a)(6)(i).] For Discontinued Models: [Provide manufacturer's model number(s).] Submit by Certified Mail to: U.S. Department of Energy, Building Technologies Program, Mailstop EE-2J, 1000 Independence Avenue, SW., Washington, DC 20585-0121. Submit by E-mail to: U.S. Department of Energy, Buildings Technologies Program, [e-mail].