Information Collection

LIHEAP Detailed Model Plan Application - FY26

IC 264445 under ICR 202401-0970-007 · OMB 0970-0075.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0075 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ADMIN_LIHEAP_DETAILED MODEL PLAN Clean Copy_FY2025.docx	Other-Detailed Model Plan Applicatio
ADMIN_LIHEAP_DETAILED MODEL PLAN Clean Copy_FY2025.docx	Other-Detailed Model Plan Applicatio

IC Title:

LIHEAP Detailed Model Plan Application - FY26

Agency IC Tracking Number:

OCS

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 96.10 45 CFR 96.42

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
Other-Detailed Model Plan Application			ADMIN_LIHEAP_DETAILED MODEL PLAN Clean Copy_FY2025.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: 207

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
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	207	207
Annual IC Time Burden (Hours)	104	104
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.