Information Collection

LIHEAP Detailed Model Plan Application - FY24

IC 211409 under ICR 202402-0970-013 · OMB 0970-0075.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2020 LIHEAP Detailed Model Plan Application.pdf	Other-Detailed Model Plan Applicatio
2020 LIHEAP Detailed Model Plan Application.pdf	Other-Detailed Model Plan Applicatio

IC Title:

Agency IC Tracking Number:

OCS

Is this a Common Form? No

IC Status: Unchanged

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			2020 LIHEAP Detailed Model Plan Application.pdf		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	Previously Approved
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.