Information Collection

State Grant Recipients - Modules II and III

IC 230201 under ICR 202503-0970-011 · OMB 0970-0449.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 State Grant Recipients - Modules II and III	Form
Form 1 LIHEAP Perforrmance Data State Grant Recipients - Modules II and III	Form
ADMIN_LIHEAP_LPDFInstructionsClean_States_FY2024toFY2026.docx	Instruction
ADMIN_LIHEAP_LPDFInstructionsClean_States_FY2024toFY2026.docx	Instruction
1 LIHEAP Perforrmance Data ADMIN_LIHEAP_LPDFTemplateClean_States_FY2024toFY2026.docx	Form
1 LIHEAP Perforrmance Data ADMIN_LIHEAP_LPDFTemplateClean_States_FY2024toFY2026.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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				Yes	Yes	Fillable Printable
Instruction					Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 51

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	51	51
Annual IC Time Burden (Hours)	8,089	8,089
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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].