ENERGY STAR Partnership Name Change Request
ENERGY STAR
®
Partnership Name Change Request
Through this form, ____________________________________ (The current Organization Name
for ENERGY STAR Partnership), requests for the name of its organization associated with the
ENERGY STAR partnership to be changed in EPA records to the partnership name indicated below.
New Organization Name for ENERGY STAR Partnership:
_______________________________________________________________________
Reason for Organization Name Change:
_______________________________________________________________________
By signing below, the submitter of this form affirms that they have the authority to execute this
partnership name change on behalf of ____________________________________ (New
Organization Name for ENERGY STAR Partnership). Following receipt and review of this form,
EPA will update its records. This form is limited to organization name changes only; changes to the
scope or nature of your ENERGY STAR partnership should be communicated through a
partnership agreement form.
Date new organization name for ENERGY STAR partnership takes effect:
_________________________
Signature: ____________________________________
Submitter Name (printed): ____________________________________
Submitter Job Title: ____________________________________
Date (MM/DD/YYYY): ____________________________________
Please submit this form to:
Products and EEPS partners: join@energystar.gov
Residential New Construction partners: energystarhomes@energystar.gov
Buildings & plants partners: https://portfoliomanager.zendesk.com/hc/en-us/requests/new
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