Information Collection

Quarterly Performance and Management Report for LIHWAP

IC 249838 under ICR 202110-0970-011 · OMB 0970-0578.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0578 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Quarterly Performance and Management Report for LIHWAP	Form
LIHWAP_Quarterly_Report_Instructions_Draft_10.14.21_IOAS OS Apprvd.docx	Instruction
LIHWAP_Quarterly_Report_Instructions_Draft_10.14.21_IOAS OS Apprvd.docx	Instruction
1 LIHWAP Quarterly Report LIHWAP Quarterly Report_FY21_10.14.21.xlsx	Form
1 LIHWAP Quarterly Report LIHWAP Quarterly Report_FY21_10.14.21.xlsx	Form

IC Title:

Quarterly Performance and Management Report for LIHWAP

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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
Form	1	LIHWAP Quarterly Report	LIHWAP Quarterly Report_FY21_10.14.21.xlsx		Yes	Yes	Fillable Fileable
Instruction			LIHWAP_Quarterly_Report_Instructions_Draft_10.14.21_IOAS OS Apprvd.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: 157

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Farms

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	628	628
Annual IC Time Burden (Hours)	8,164	8,164
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.