Form No.

EEC Form 3

Form Title AEECR

(Choose Month)
Republic of the Philippines
January
DEPARTMENT OF ENERGY February
Energy Utilization Management Bureau
March
EEC FORM 3 April
ANNUAL ENERGY EFFICIENCY AND CONSERVATION REPORT (AEECR) May
June
CY 20__ July
August
Name of Establishment September
Address October
Sector (Put an "x" at the left side) Commercial Industrial Transportation November
Type of Business December
Total Number of Employees No. of Male No. of Female

PART A.
ENERGY CONSERVATION PROJECTS AND MEASURES

A.1 FOR ON-GOING PROJECT/S

Energy Savings
Energy Conservation Project/s Estimated Date
No. Date Started Upon Total Investment
Measures of Completion Current
Complettion

Note Use another sheet provided if needed.

Total 0.00 0.00 ₱ -

A.2 FOR COMPLETED PROJECT/S

Energy Conservation Project/s

No. Date Started Date Completed Energy Savings Total Investment
Measures

Note Use another sheet provided if needed. Total 0.00 ₱ -

 A.3 RECOMMENDED ENERGY CONSERVATION MEASURES IN THE OFFICE

Estimated Expenses/
No. Energy Conservation Project/s Measures Estimated Energy Savings Problems/Constraits
Investment

Note Use another sheet provided if needed.

PART B.
TARGET AND ACTUAL ENERGY CONSUMPTION

B.1 ACTUAL ENERGY CONSUMPTION FOR THE LAST FIVE (5) YEARS

Five Year Consumption1 (in kWh)

No. Fuel Type Unit
Year - 5 Year - 4 Year - 3 Year - 2 Year - 1

1 Gasoline kWh

2 Diesel kWh

3 Fuel Oil kWh

4 Kerosene kWh

5 LPG kWh

6 AVGAS kWh

7 AVTURBO kWh

8 Watse Oil kWh

9 Coal kWh

10 Bagasse kWh

11 Steam kWh

12 Electricity KWh

13 Others 1

13 Others 2

13 Others 3

Total 0.00 0.00 0.00 0.00 0.00

Note 1
Kindly indicate the exact year from the current year the form is accomplished.
 B.1 ENERGY CONSUMPTION FOR THE CURRENT YEAR

Year
No. Fuel Type
Unit Projected Consumption by the end of year

1 Gasoline L

2 Diesel L

3 Fuel Oil L

4 Kerosene L

5 LPG L

6 AVGAS L

7 AVTURBO L

8 Watse Oil L

9 Coal MT

10 Bagasse MT

11 Steam MT

12 Electricity kWh

13 Others 1

14 Others 2

15 Others 3

Total 0.00 0.00

Note 1
Month should be based on the submission of date of the report.

PART C.
TARGET ENERGY CONSUMPTION IN PRODUCTION

C.1 ENERGY CONSUMPTION

Production Line/Activity
No. Energy Source Unit
Prod. 1 / Act. 1 Prod. 2 / Act. 2 Prod. 3 / Act. 3 Prod. 4 / Act. 4

1 Gasoline L

2 Diesel L

3 Fuel Oil L

4 Kerosene L

5 LPG L

6 AVGAS L

7 AVTURBO L

8 Watse Oil L

9 Coal MT

10 Bagasse MT

11 Steam MT

12 Electricity KWh

13 Others 1

14 Others 2

15 Others 3

Total 0.00 0.00 0.00 0.00

 C.2 PRODUCTION VOLUME

Production Line/Activity
No. Energy Source
Prod. 1 / Act. 1 Prod. 2 / Act. 2 Prod. 3 / Act. 3 Prod. 4 / Act. 4

1 Unit

2 Quantity

3 Rated Capacity

4 PSIC Code

PART D
SPECIFIC ENERGY CONSUMPTION
(To be filled by DOE)

Production Line/Activity
No. Energy Source
Prod. 1 / Act. 1 Prod. 2 / Act. 2 Prod. 3 / Act. 3 Prod. 4 / Act. 4

1 SEC

2 Percent Reduction

Required Attachments: 1. Details of Company's Conservation Program and proposed measures to achieve above mentioned energy consumption targets.

2. Details of Company's current or proposed organization to implement their Energy Conservation Program.

Prepared by Approved by

(Signature) (Signature)

[Name] [Name]

[Position] [Position]

[Department/Unit] [Department/Unit]

[Contact Number] [Contact Number]

[E-Mail Address] [E-Mail Address]

[Date Accomplished - dd/mm/yyyy] [Date Accomplished - dd/mm/yyyy]

 Form No. EEC Form 3

Form Title AEECR

Republic of the Philippines

DEPARTMENT OF ENERGY
Energy Utilization Management Bureau

EEC FORM 3
ANNUAL ENERGY EFFICIENCY AND CONSERVATION REPORT (AEECR)
COMMERCIAL DESIGNATED ESTABLISHMENTS

CY 20__

ENERGY CONSERVATION PROJECTS AND MEASURES

A.1 FOR ON-GOING PROJECT/S

Energy Savings
Energy Conservation Project/s Estimated Date
No. Date Started Upon Total Investment
Measures of Completion Current
Complettion

10

11

12

13

14

15

Total 0.00 0.00 ₱ -

A.2 FOR COMPLETED PROJECT/S

Energy Conservation Project/s

No. Date Started Date Completed Energy Savings Total Investment
Measures

10

11

12

13

14

15

Total 0.00 ₱ -
 A.3 RECOMMENDED ENERGY CONSERVATION MEASURES IN THE OFFICE

Estimated Expenses/
No. Energy Conservation Project/s Measures Estimated Energy Savings Problems/Constraits
Investment

10