OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application Requirements for the Low Income Home Energy Assistance Program (LIHEAP) Model Plan

ICR 201404-0970-012 · OMB 0970-0075 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1 LIHEAP Abbreviated Model Plan Form and Instruction Removed Available
Form 1 Plan (future years) Form and Instruction New Repair queued
Form 1 LIHEAP Program Integrity Assessment and Plan Form and Instruction Removed Repair queued
Form 1 LIHEAP Detailed Model Plan Form and Instruction Removed Repair queued
LIHEAP Model Plan Supporting Statement 06 23 2014.docx Supporting Statement A Uploaded 2014-06-23 Available
IC Document Collections
IC IDCollectionTypeStatusForm
9831 LIHEAP Abbreviated Model Plan Form and Instruction Removed
211409 Plan (future years) Form and Instruction New
211408 PLAN (first year-FY 2015) New
192860 LIHEAP Program Integrity Assessment and Plan Form and Instruction Removed
185539 LIHEAP Detailed Model Plan Form and Instruction Removed
ICR Details
0970-0075 201404-0970-012
Historical Active 201012-0970-008
HHS/ACF ocs
Application Requirements for the Low Income Home Energy Assistance Program (LIHEAP) Model Plan
Revision of a currently approved collection   No
Regular
Approved with change 06/23/2014
Retrieve Notice of Action (NOA) 04/29/2014
  Inventory as of this Action Requested Previously Approved
06/30/2017 36 Months From Approved 06/30/2014
420 0 432
525 0 336
0 0 0
The data collected will be used as the application for LIHEAP block grant funding to determine the state, tribal and territorial grantees of LIHEAP funds for each fiscal year in order to carry out the requirements of Section 2605(b) of the LIHEAP statute.
US Code: 42 USC 8624 Name of Law: Low Income Energy Assistance Act
  
None
Not associated with rulemaking
  79 FR 4346 01/27/2014
79 FR 22818 04/24/2014
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 420 432 0 -12 0 0
Annual Time Burden (Hours) 525 336 0 189 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
The system shows a burden increase because the first year is an annual estimate of 420 hours per year, and years two and three are each 105 hours per year. The average annual burden for the three years is 210 hours per year.
$34,650
No
No
No
No
No
Uncollected
Robert Sargis 2026907275
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/29/2014