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 Household Report Short Form	Form	Modified	Available
Form 1 Household Report Long Form	Form	Modified	Available
COMM_LIHEAP_OMB_NonSubRequestChange_HHR_082520.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2020-08-26	Available
COMM_OMB_SupportingStmt_HHR_Final CLEAN.docx	Supporting Statement A	Uploaded 2020-08-26	Available
LIHEAP Household Report.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2013-04-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
184199	LIHEAP Household Report–Short Format	Form	Modified	Household Report Short Form
184199	LIHEAP Household Report–Short Format	Instruction	Modified
184198	LIHEAP Household Report–Long Format	Form	Modified	Household Report Long Form
184198	LIHEAP Household Report–Long Format	Instruction	Modified

ICR Details

OMB Control No: 0970-0060	ICR Reference No: 202008-0970-012
Status: Historical Active	Previous ICR Reference No: 201811-0970-007
Agency/Subagency: HHS/ACF	Agency Tracking No: OCS
Title: Low Income Home Energy Assistance Program (LIHEAP) Household Report
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/31/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/26/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2022	02/28/2022	02/28/2022
Responses	204	0	216
Time Burden (Hours)	2,704	0	2,344
Cost Burden (Dollars)	0	0	0

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Abstract: The LIHEAP statute requires the collection of data on the number of households assisted, their income levels, and vulnerability group, by type of LIHEAP assistance, for inclusion in the Secretary's annual LIHEAP Report to Congress. Over the years, the LIHEAP statute, as amended, has expanded the household data requirements. The data are collected through the LIHEAP Household Report which consists of the following: (1) Long Format and (2) Short Format. OCS requests that OMB approval of the LIHEAP Household Report be extended from FY 2016 through FY 2018 to include an unduplicated count of: • Assisted and applicant households, by type of LIHEAP assistance; • Assisted and applicant households, by type of LIHEAP assistance and poverty level; • Assisted households receiving nominal payments of $50 or less; • Assisted households receiving only utility payment assistance; this information will automatically be transferred to the grantee's Performance Data Form. • Assisted households, regardless of the type(s) of LIHEAP assistance, excluding households that only receive nominal payments of $50 or less; • Assisted households, by type of LIHEAP assistance, having at least one member 60 years or older, disabled, or five years old or younger; • Assisted households, by type of LIHEAP assistance, with at least one member age 2 years or under; • Assisted households, by type of LIHEAP assistance, with at least one member ages 3 years through 5 years; and • Assisted households, regardless of the type(s) of LIHEAP assistance, having at least one member 60 years or older, disabled, or five years old or younger. The purpose of the non-substantive and time sensitive changes to the LIHEAP Household Report is to meet statutory requirements related to the CARES Act stimulus funding and potential other supplemental funding from Congress.

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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: PL: Pub.L. 116 - 136 Title VIII of Division B Name of Law: Coronavirus Aid, Relief, and Economic Security Act (the CARES Act)

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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:
	83 FR 41075	08/17/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 53637	10/24/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
LIHEAP Household Report–Long Format	1	Household Report Long Form
LIHEAP Household Report–Short Format	1	Household Report Short Form

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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	204	216	0	-12	0	0
Annual Time Burden (Hours)	2,704	2,344	372	-12	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to: Changing Regulations

Short Statement: ACF is requesting additional burden hours to accommodate the separate tracking and reporting of the CARES Act LIHEAP funding that Congress appropriated on March 27, 2020 and potential other supplemental funding from Congress. Separate reporting is a requirement of the terms and conditions of the grant awards for supplemental funding. ACF also proposes to decrease the number of respondents for the Short Format from 160 to 148 due to a recent reassessment of reporting grantees.

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Annual Cost to Federal Government: $28,908

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

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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: 08/26/2020

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