Information Collection

Low Income Household Water Assistance Program (LIHWAP) Program Development

IC 246360 under ICR 202105-0970-017 · OMB 0970-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ADMIN_LIHWAP_Draft Input Survey_NonSub Change (Clean).docx	Other-Survey
ADMIN_LIHWAP_Draft Input Survey_NonSub Change (Clean).docx	Other-Survey
ADMIN_LIHWAP_Draft Survey Supporting Statement A_04092021.docx Supporting Statement - Formative GenIC for Program Support: LIHWAP Program Development Survey	IC Document
ADMIN_LIHWAP_Draft Survey Supporting Statement A_04092021.docx Supporting Statement - Formative GenIC for Program Support: LIHWAP Program Development Survey	IC Document
ADMIN_LIHWAP Survey_NonSub Change Request_040921.docx NonSub Change Request - LIHWAP - Add State Plan Review Questions	IC Document
ADMIN_LIHWAP Survey_NonSub Change Request_040921.docx NonSub Change Request - LIHWAP - Add State Plan Review Questions	IC Document

IC Title:

Low Income Household Water Assistance Program (LIHWAP) Program Development

Agency IC Tracking Number:

OCS

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			ADMIN_LIHWAP_Draft Input Survey_NonSub Change (Clean).docx		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: 220

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: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	220	220
Annual IC Time Burden (Hours)	176	176
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement - Formative GenIC for Program Support: LIHWAP Program Development Survey	ADMIN_LIHWAP_Draft Survey Supporting Statement A_04092021.docx	04/13/2021
NonSub Change Request - LIHWAP - Add State Plan Review Questions	ADMIN_LIHWAP Survey_NonSub Change Request_040921.docx	04/13/2021

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