Information Collection

Quarterly Performance and Management Report

IC 251558 under ICR 202202-0970-003 · OMB 0970-0589.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0589 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	Form
LIHEAP_Quarterly_Report_Instructions_1.27.22.docx	Instruction
LIHEAP_Quarterly_Report_Instructions_1.27.22.docx	Instruction
1 LIHEAP Quarterly Performance and Management Report RPT_LIHEAP Quarterly Performance and Managment Report_FY22 1.27.22.xlsx	Form
1 LIHEAP Quarterly Performance and Management Report RPT_LIHEAP Quarterly Performance and Managment Report_FY22 1.27.22.xlsx	Form

IC Title:

Quarterly Performance and Management Report

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	LIHEAP Quarterly Performance and Management Report	RPT_LIHEAP Quarterly Performance and Managment Report_FY22 1.27.22.xlsx		Yes	Yes	Fillable Fileable
Instruction			LIHEAP_Quarterly_Report_Instructions_1.27.22.docx		Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 206

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	206	206
Annual IC Time Burden (Hours)	7,416	7,416
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.