Information Collection

Sub-Grant Recipients (in states with sub-grant recipient managed systems) - Modules II and III

IC 230202 under ICR 202503-0970-011 · OMB 0970-0449.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Sub-Grant Recipients (in states with sub-grant recipient managed systems) - Modules II and III	Form
Form 1 LIHEAP Performance Data Form Sub-Grant Recipients (in states with sub-grant recipient managed systems) - Modules II and III	Form
ADMIN_LIHEAP_LPDFInstructionsClean_States_FY2024toFY2026.docx	Instruction
ADMIN_LIHEAP_LPDFInstructionsClean_States_FY2024toFY2026.docx	Instruction
1 LIHEAP Performance Data Form ADMIN_LIHEAP_LPDFTemplateClean_States_FY2024toFY2026.docx	Form
1 LIHEAP Performance Data Form 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: 100

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

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	100	100
Annual IC Time Burden (Hours)	630	630
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.

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