Information Collection

LIHEAP Quarterly Performance and Management Report

IC 251558 under ICR 202602-0970-013 · OMB 0970-0589.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 LIHEAP Quarterly Report LIHEAP Quarterly Performance and Management Report	Form
LIHEAP_Quarterly_Report_OLDC_Instructions_FY2025_Q3 Q4_2.27.26.docx	Instruction
1 LIHEAP Quarterly Report LIHEAP-AT-2025-01-Quarterly-Report-Sample-Form_FY25_ Q3 Q4 changes CLEAN 092925.xlsx	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 Fileable
Instruction					Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 185

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	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	740	534	206
Annual IC Time Burden (Hours)	11,840	4,424	7,416
Annual IC Cost Burden (Dollars)	0	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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