Residential Lighting Efficiency Assessment Form

Assessor Name Date Property Address Homeowner Name Lighting Inventory

Room/Area	Light Fixture Type	Number of Fixtures	Current Bulb Type	Wattage per Bulb	Estimated Daily Usage (hours)	Notes
			Incandescent Halogen CFL LED Other
			Incandescent Halogen CFL LED Other

Assessment Summary & Recommendations Potential Lighting Upgrade Areas Additional Comments