Information Collection

Weatherization Assistance Program Evaluation

IC 189979 under ICR 200907-1910-004 · OMB 1910-5151.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-5151 can be found here:

Documents and Forms

Document Name Document Type
DF1 ALL STATES AGENCIES INFORMATION DATA FORM for OMB v1.doc Other-Survey
DF2 HOUSING UNIT INFORMATION DATA FORM for OMB - final 2nov09.doc Other-Survey
DF3 BUILDING INFORMATION DATA FORM for OMB - final 2nov09.doc Other-Survey
DF4 ELECTRIC & NAT GAS BILLS INFO FROM AGENCIES for OMB final.doc Other-Survey
DF5_ELECTRIC__NAT_GAS_BILLS_INFO_FROM_UTILITIES_for_OMB_-_Electric_Version_3.doc Other-Survey
DF5_ELECTRIC__NAT_GAS_BILLS_INFO_FROM_UTILITIES_for_OMB_-_Gas_Version_3.doc Other-Survey
DF6 METERED FUELS & AC STUDY for OMB - final.doc Other-Survey
DF10 All Agencies Program Overview Data Form - for OMB - final.doc Other-Survey
S1 ALL STATES PROGRAM INFORMATION SURVEY for OMB V2.doc Other-Survey
S2 ALL AGENCIES PROGRAM INFORMATION SURVEY for OMB V2.doc Other-Survey
S3 SUBSET OF AGENCIES DETAILED PROG INFO SURVEY for OMB.doc Other-Survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Weatherization Assistance Program Evaluation	Agency IC Tracking Number:	Bruce Tonn

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 10 CFR 440

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	DF2 HOUSING UNIT INFORMATION DATA FORM for OMB - final 2nov09.doc	Yes	No	Fillable Printable
Other-Survey	DF3 BUILDING INFORMATION DATA FORM for OMB - final 2nov09.doc	Yes	No	Fillable Printable
Other-Survey	DF6 METERED FUELS & AC STUDY for OMB - final.doc	Yes	No	Fillable Printable
Other-Survey	DF10 All Agencies Program Overview Data Form - for OMB - final.doc	Yes	No	Fillable Printable
Other-Survey	S1 ALL STATES PROGRAM INFORMATION SURVEY for OMB V2.doc	Yes	No	Fillable Printable
Other-Survey	DF4 ELECTRIC & NAT GAS BILLS INFO FROM AGENCIES for OMB final.doc	Yes	No	Fillable Printable
Other-Survey	DF5_ELECTRIC__NAT_GAS_BILLS_INFO_FROM_UTILITIES_for_OMB_-_Electric_Version_3.doc	Yes	No	Fillable Printable
Other-Survey	DF5_ELECTRIC__NAT_GAS_BILLS_INFO_FROM_UTILITIES_for_OMB_-_Gas_Version_3.doc	Yes	No	Fillable Printable
Other-Survey	S2 ALL AGENCIES PROGRAM INFORMATION SURVEY for OMB V2.doc	Yes	No	Fillable Printable
Other-Survey	S3 SUBSET OF AGENCIES DETAILED PROG INFO SURVEY for OMB.doc	Yes	No	Fillable Printable
Other-Survey	DF1 ALL STATES AGENCIES INFORMATION DATA FORM for OMB v1.doc	Yes	No	Fillable Printable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,950	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 92 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	1,950	1,950
Annual IC Time Burden (Hours)	69,136	69,136
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.