Information Collection

Low Income Home Energy Assistance Program (LIHEAP) Grantee Survey

IC 9834 under ICR 201304-0970-008 · OMB 0970-0076.

Documents and Forms

Document Name Document Type
Form 1 Low Income Home Energy Assistance Program (LIHEAP) Grantee Survey Form
1 LIHEAP GRANTEE SURVEY Sample survey10$.xls Form
survey10 Instructions_11-29-10.final.doc SURVEY INSTRUCTIONS IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Low Income Home Energy Assistance Program (LIHEAP) Grantee Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	LIHEAP GRANTEE SURVEY	Sample survey10$.xls		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 51	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	51	51
Annual IC Time Burden (Hours)	179	179
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SURVEY INSTRUCTIONS	survey10 Instructions_11-29-10.final.doc	02/17/2011

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