Home Energy Efficiency Assessment Report

Homeowner Information

Name:

Address:

Assessment Date:

Assessor Name:

Property Details

Type:

Year Built:

Size (sq.ft.):

Number of Occupants:

Summary of Assessment

Current Energy Usage

Utility	Annual Usage	Annual Cost
Electricity
Natural Gas
Water
Other

Building Envelope Assessment

Windows:
Doors:
Insulation (walls/attic):
Air Leakage:

Systems Assessment

Heating System:
Cooling System:
Water Heater:
Major Appliances:
Lighting:

Recommendations

Potential Upgrades and Estimated Savings

Upgrade	Estimated Cost	Estimated Annual Savings

Next Steps