State Grantees Module 1 - Energy Vendors

Low Income Home Energy Assistance Program (LIHEAP) Performance Data Form

Documents and Forms

Document Name Document Type
Form 1 State Grantees Module 1 - Energy Vendors Form
ADMIN_LIHEAP_CARESActRevisedLPDFInstructions_FY2020_clean.docx Instruction
ADMIN_LIHEAP_CARESActRevisedLPDFInstructions_FY2020_clean.docx Instruction
1 LIHEAP Performance Data ADMIN_LIHEAP_CARESActRevisedLPDF_FY2020.pdf Form
1 LIHEAP Performance Data ADMIN_LIHEAP_CARESActRevisedLPDF_FY2020.pdf Form

Information Collection (IC) Details

IC Title:	State Grantees Module 1 - Energy Vendors	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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 Performance Data	ADMIN_LIHEAP_CARESActRevisedLPDF_FY2020.pdf		Yes	Yes	Fillable Fileable
Instruction			ADMIN_LIHEAP_CARESActRevisedLPDFInstructions_FY2020_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: 1,530	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 %

	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-1,530	1,530
Annual IC Time Burden (Hours)	-1,530	1,530
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.