Information Collection

Residential Utility Disconnections Survey

IC 271616 under ICR 202410-1905-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form EIA-112 Residential Utility Disconnections Survey	Form and Instruction
EIA112_Instructions.docx	Instruction
EIA112_Instructions.docx	Instruction
EIA-112 Residential Utility Disconnections Survey EIA-112 Forms and Instructions.xlsx	Form and Instruction
EIA-112 Residential Utility Disconnections Survey EIA-112 Forms and Instructions.xlsx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 5 CFR 1320.5

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 and Instruction	EIA-112	Residential Utility Disconnections Survey	EIA-112 Forms and Instructions.xlsx		Yes	Yes	Fillable Fileable
Instruction			EIA112_Instructions.docx		Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Supply

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,130

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,130	1,130
Annual IC Time Burden (Hours)	2,260	2,260
Annual IC Cost Burden (Dollars)	206,022	206,022

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.