OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Low Income Home Energy Assistance (LIHEAP) Leveraging Report

ICR 201703-0970-004 · OMB 0970-0121 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1 Low Income Home Energy Assistance (LIHEAP) Leveraging Report Form Modified Repair queued
OMB-lev-supstat.docx Supporting Statement A Uploaded 2017-03-13 Repair queued
LIHEAP Leveraging Report.docx Justification for No Material/Nonsubstantive Change Uploaded 2013-04-29 Available
levinstr[1].doc Supplementary Document Uploaded 2012-02-17 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
9857 Low Income Home Energy Assistance (LIHEAP) Leveraging Report Form Modified
ICR Details
0970-0121 201703-0970-004
Historical Active 201304-0970-007
HHS/ACF 19402
Low Income Home Energy Assistance (LIHEAP) Leveraging Report
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 06/16/2017
Retrieve Notice of Action (NOA) 03/15/2017
  Inventory as of this Action Requested Previously Approved
06/30/2020 36 Months From Approved
70 0 0
2,660 0 0
0 0 0
The data collected will be used to determine the amount of nonfederal home energy resources that LIHEAP grantees have leveraged for low income households in carrying out the provisions of Section 96.87 of the LIHEAP regulations.
PL: Pub.L. 95 - 35 2607A Name of Law: LIHEAP Act
  
None
Not associated with rulemaking
  81 FR 18857 04/01/2016
82 FR 13456 03/13/2017
No
1
IC Title Form No. Form Name
Low Income Home Energy Assistance (LIHEAP) Leveraging Report 1 LIHEAP Leveraging Report
  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 70 0 0 70 0 0
Annual Time Burden (Hours) 2,660 0 0 2,660 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
No change in burden hours
$11,200
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.
03/15/2017