Low Income Home Energy Assistance Program (LIHEAP) Household Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Long Applicant '08	Form	Modified	Available
Form 1 Long Format Applicants '10	Form	Modified	Available
Form 1 Applicant '09	Form	Modified	Available
Form 1 short	Form	New	Available
Form 1 09	Form	New	Available
Form short short format	Form	New	Available
Form 1 Assisted 09	Form	New	Repair queued
Form 1 Assisted 09	Form	New	Available
Form 1 Assisted 08	Form	New	Available
Attachments to LIHEAP Household Report_100108.pdf	Supplementary Document	Uploaded 2008-10-02	Available
Proposed LIHEAP Household Reports for FY 09 -FY 11.pdf	Supplementary Document	Uploaded 2008-10-01	Available
HH-supstatrev 9-29-08 (FY 09-11) (3).doc	Supporting Statement A	Uploaded 2008-10-02	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9825	Long Format for Applicants	Form	Modified	Long Applicant '08
9825	Long Format for Applicants	Form	Modified	Long Format Applicants '10
9825	Long Format for Applicants	Form	Modified	Applicant '09
184199	Short Format	Form	New	short
184199	Short Format	Form	New	09
184199	Short Format	Form	New	short format
184198	Long Format for Assisted	Form	New	Assisted 09
184198	Long Format for Assisted	Form	New	Assisted 09
184198	Long Format for Assisted	Form	New	Assisted 08

ICR Details

OMB Control No: 0970-0060	ICR Reference No: 200803-0970-010
Status: Historical Active	Previous ICR Reference No: 200309-0970-001
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Low Income Home Energy Assistance Program (LIHEAP) Household Report
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/06/2008
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/24/2008
Terms of Clearance: This ICR is approved as revised by ACF. As part of this revision, we understand ACF plans to add a new data element beginning in FY 2011 to the LIHEAP Household Report -- Long Format for Assisted Households. We note a PRA violation for FY 2007 and remind ACF to submit timely.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2011	36 Months From Approved
Responses	248	0	0
Time Burden (Hours)	10,700	0	0
Cost Burden (Dollars)	10,664	0	0

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Abstract: The data are needed to comply with statutory requirements and Congressional requests for data under the Human Services Amendments of 1994 (Pub. Law 103-252). The data will be included as part of the Department's annual LIHEAP report to Congress. The data are also used to measure LIHEAP targeting performance under the Government Performance Results Act of 1993. The respondents include states, direct-grant Indian tribes and tribal organizations, and insular areas which receive LIHEAP grants from the Department. The reports provide basic oversight data.

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Authorizing Statute(s): US Code: 42 USC 8624 Name of Law: Omnibus Reconciliation Act of 1981
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 50923	08/28/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 57584	10/10/2007
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Long Format for Applicants	1, 1, 1	Applicant '09 ,   Long Format Applicants '10 ,   Long Applicant '08
Long Format for Assisted	1, 1, 1	Assisted 08 ,   Assisted 09 ,   Assisted 09
Short Format	short, 1, 1	short format ,   09 ,   short

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	248	0	0	248	0	0
Annual Time Burden (Hours)	10,700	0	0	10,700	0	0
Annual Cost Burden (Dollars)	10,664	0	0	10,664	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: LIHEAP grantees collect and report data on LIHEAP assisted households as part of their household application process. OCS prepares the data on assisted households for the Department's Annual LIHEAP Report to Congress, as required by Section 2610(a)(4) and (5) of the Act (42 U.S.C. 8629(b) and Section 2605(c)(1)(G) of the Act (42 U.S.C. 8624). In addition, the data are used for Congressional oversight and in response to Congressional and White House queries on caseload statistics and demographic characteristics of LIHEAP households. Finally, the data elements on heating assisted households containing at least one member who is elderly or a young child are used in calculating LIHEAP targeting performance measures, and the data on assisted households are used in calculating a LIHEAP efficiency measure in response to OMB's Program Assessment Rating Tool.

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Annual Cost to Federal Government: $27,729

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/24/2008

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