Information Collection

State Grantees Module 1 - Energy Vendors

IC 244825 under ICR 202112-0970-006 · OMB 0970-0449.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0449 can be found here:

Documents and Forms

Documents and forms in this information collection
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

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:

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	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 %

table that charts list of burden
	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

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.