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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.