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 201708-0970-008 · OMB 0970-0075 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1 Plan (future years) Form and Instruction Unchanged Repair queued
LIHEAP Model Plan Supporting Statement 051617.docx Supporting Statement A Uploaded 2017-08-22 Available
IC Document Collections
IC IDCollectionTypeStatusForm
211409 Plan (future years) Form and Instruction Unchanged
211408 PLAN (first year-FY 2015) Removed
ICR Details
0970-0075 201708-0970-008
Historical Active 201404-0970-012
HHS/ACF ocs
Application Requirements for the Low Income Home Energy Assistance Program (LIHEAP) Model Plan
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 09/28/2017
Retrieve Notice of Action (NOA) 08/22/2017
  Inventory as of this Action Requested Previously Approved
09/30/2020 36 Months From Approved 06/30/2017
210 0 210
105 0 420
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
  82 FR 16214 04/03/2017
82 FR 39790 08/22/2017
No
1
IC Title Form No. Form Name
PLAN (first year-FY 2015)
Plan (future years) 1 Plan
  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 210 210 0 -210 0 210
Annual Time Burden (Hours) 105 420 0 -420 0 105
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
Removed an IC for administrative reasons.
$34,650
No
    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.
08/22/2017