Agency_____________________________  Prepared by:____________________________

Reported Year: FY 1996  Date Submitted:___________  Phone:___________________

GROSS SQUARE FOOTAGE
Buildings/Facilities                    Excluded Buildings/Industrial
Gross Square Feet, Thou.______________  Gross Square Feet, Thou._____________

ENERGY CONSUMPTION AND COST DATA
(Breakdown of energy types is optional for the annual report accompanying
agency budget materials, but the data should be available at least for
FY 1996 from the agency's recently-completed FEMP submission.)

Buildings/Facilities            Annual Consumption      Annual Cost (Thou. $)
Electricity     MWH             __________________      _____________________
Fuel Oil        Thou. Gal.      __________________      _____________________
Natural Gas     Thou. Cu. Ft.   __________________      _____________________
LPG/Propane     Thou. Gal.      __________________      _____________________
Coal            S. Ton          __________________      _____________________
Purch. Steam    BBtu            __________________      _____________________
Other           BBtu            __________________      _____________________
                Total Buildings/Facilities Costs        _____________________

Excluded Buildings/Industrial   Annual Consumption      Annual Cost (Thou. $)
Electricity     MWH             __________________      _____________________
Fuel Oil        Thou. Gal.      __________________      _____________________
Natural Gas     Thou. Cu. Ft.   __________________      _____________________
LPG/Propane     Thou. Gal.      __________________      _____________________
Coal            S. Ton          __________________      _____________________
Purch. Steam    BBtu            __________________      _____________________
Other           BBtu            __________________      _____________________
                Total Excluded Bldgs/Indust Fac. Costs  _____________________

DIRECT AGENCY EXPENDITURES -- Direct expenditures on facility energy
efficiency improvements
FY 1996 Expenditures (Thou. $)______________________
Annual savings anticipated from expenditures_________________ MMBTU
                                            _________________(Thou. $)

ENERGY SAVINGS PERFORMANCE CONTRACTS
Number of ESP contracts awarded_________________
Annual savings anticipated from ESP contracts________________MMBTU
                                             ________________(Thou. $)
UTILITY INCENTIVES
Incentives received____________________(Thou. $)
Funds spent in order to receive incentives_____________________(Thou. $)
Annual savings anticipated from DSM activities________________MMBTU
                                              ________________(Thou. $)
TRAINING
Current year expenditures for energy management training_____________(Thou. $)
Number of personnel trained_______________________