Information Collection

Weatherization Assistance Program Sub-programs - State, Local or Tribal Government

IC 210941 under ICR 202202-1910-003 · OMB 1910-5157.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-5157 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DOE F 540.2 Weatherization Assistance Program Sub-programs - State, Local or Tribal Government	Form and Instruction
DOE F 540.2 Community Scale Form - Annual File Worksheet DOE F 540.2 Community Scale Form - Annual File Worksheet- Final.pdf	Form and Instruction
DOE F 540.2 Community Scale Form - Annual File Worksheet DOE F 540.2 Community Scale Form - Annual File Worksheet- Final.pdf	Form and Instruction
DOE F 540.2 SERC Form - Annual File Worksheet DOE F 540.2 SERC Form - Annual File Worksheet_ Final.pdf	Form and Instruction
DOE F 540.2 SERC Form - Annual File Worksheet DOE F 540.2 SERC Form - Annual File Worksheet_ Final.pdf	Form and Instruction
DOE F 540.4 Community Scale Form - T&TA. Monitoring, and Leveraging DOE F 540.4 Community Scale Form - T&TA. Monitoring, and Leveraging Report- Final.pdf	Form and Instruction
DOE F 540.4 Community Scale Form - T&TA. Monitoring, and Leveraging DOE F 540.4 Community Scale Form - T&TA. Monitoring, and Leveraging Report- Final.pdf	Form and Instruction
DOE F 540.4 SERC Form - T&TA. Monitoring, and Leveraging Report DOE F 540.4 SERC Form - T&TA. Monitoring, and Leveraging Report_Final.pdf	Form and Instruction
DOE F 540.4 SERC Form - T&TA. Monitoring, and Leveraging Report DOE F 540.4 SERC Form - T&TA. Monitoring, and Leveraging Report_Final.pdf	Form and Instruction
DOE F 540.5 E&I Form - Subgrantee Information Worksheet DOE F 540.5 E&I Form - Subgrantee Information Worksheet- Final.docx	Form and Instruction
DOE F 540.5 E&I Form - Subgrantee Information Worksheet DOE F 540.5 E&I Form - Subgrantee Information Worksheet- Final.docx	Form and Instruction
DOE F 540.6 E&I Form - Historic Preservation DOE F 540.6 E&I Form - Historic Preservation- Final.docx	Form and Instruction
DOE F 540.6 E&I Form - Historic Preservation DOE F 540.6 E&I Form - Historic Preservation- Final.docx	Form and Instruction
DOE F 540.7 E&I Form - Annual Report DOE F 540.7 E&I Form - Annual Report- Final.docx	Form and Instruction
DOE F 540.7 E&I Form - Annual Report DOE F 540.7 E&I Form - Annual Report- Final.docx	Form and Instruction
DOE F 540.8 E&I Form - Grant File DOE F 540.8 E&I Form - Grant File- Final.docx	Form and Instruction
DOE F 540.8 E&I Form - Grant File DOE F 540.8 E&I Form - Grant File- Final.docx	Form and Instruction
DOE F 540.9 E&I Form - QPR DOE F 540.9 E&I Form - QPR- Final.docx	Form and Instruction
DOE F 540.9 E&I Form - QPR DOE F 540.9 E&I Form - QPR- Final.docx	Form and Instruction
DOE F 540.11 SERC Form - QPR DOE F 540.11 SERC Form - QPR - Final.docx	Form and Instruction
DOE F 540.11 SERC Form - QPR DOE F 540.11 SERC Form - QPR - Final.docx	Form and Instruction
DOE F 540.12 Community Scale Form - QPR DOE F 540.12 Community Scale Form - QPR- Final.docx	Form and Instruction
DOE F 540.12 Community Scale Form - QPR DOE F 540.12 Community Scale Form - QPR- Final.docx	Form and Instruction
Legal Authority Community Scale Form - Statute Language-Final.docx Legal Authority Community Scale Form	IC Document
Legal Authority Community Scale Form - Statute Language-Final.docx Legal Authority Community Scale Form	IC Document
Legal Authority E&I 42 USC 6864d-Final.pdf Legal Authority E&I 42 USC 6864d	IC Document
Legal Authority E&I 42 USC 6864d-Final.pdf Legal Authority E&I 42 USC 6864d	IC Document
Legal Authority SERC 42 USC 6872_ Final.pdf Legal Authority SERC 42 USC 6872	IC Document
Legal Authority SERC 42 USC 6872_ Final.pdf Legal Authority SERC 42 USC 6872	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Weatherization Assistance Program Sub-programs - State, Local or Tribal Government

Agency IC Tracking Number:

Christine Platt-Patrick (EERE)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DOE F 540.2	Community Scale Form - Annual File Worksheet	DOE F 540.2 Community Scale Form - Annual File Worksheet- Final.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 540.2	SERC Form - Annual File Worksheet	DOE F 540.2 SERC Form - Annual File Worksheet_ Final.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 540.4	Community Scale Form - T&TA. Monitoring, and Leveraging Report	DOE F 540.4 Community Scale Form - T&TA. Monitoring, and Leveraging Report- Final.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 540.4	SERC Form - T&TA. Monitoring, and Leveraging Report	DOE F 540.4 SERC Form - T&TA. Monitoring, and Leveraging Report_Final.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 540.5	E&I Form - Subgrantee Information Worksheet	DOE F 540.5 E&I Form - Subgrantee Information Worksheet- Final.docx	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 540.6	E&I Form - Historic Preservation	DOE F 540.6 E&I Form - Historic Preservation- Final.docx	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 540.7	E&I Form - Annual Report	DOE F 540.7 E&I Form - Annual Report- Final.docx	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 540.8	E&I Form - Grant File	DOE F 540.8 E&I Form - Grant File- Final.docx	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 540.9	E&I Form - QPR	DOE F 540.9 E&I Form - QPR- Final.docx	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 540.11	SERC Form - QPR	DOE F 540.11 SERC Form - QPR - Final.docx	Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 540.12	Community Scale Form - QPR	DOE F 540.12 Community Scale Form - QPR- Final.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Energy

Subfunction: Energy Conservation and Preparedness

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	406	406
Annual IC Time Burden (Hours)	1,836	1,836
Annual IC Cost Burden (Dollars)	108,908	108,908

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Legal Authority Community Scale Form	Legal Authority Community Scale Form - Statute Language-Final.docx	02/25/2022
Legal Authority E&I 42 USC 6864d	Legal Authority E&I 42 USC 6864d-Final.pdf	02/25/2022
Legal Authority SERC 42 USC 6872	Legal Authority SERC 42 USC 6872_ Final.pdf	02/25/2022

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