Short Format

Low Income Home Energy Assistance Program (LIHEAP) Household Report

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0060 can be found here:

Documents and Forms

Document Name Document Type
Form short Short Format Form
short short format hhsrptin08.xls Form
1 09 hhsrptin09.xls Form
1 short hhsrptin10.xls Form

Information Collection (IC) Details

IC Title:	Short Format	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 34 CFR 45

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	short	short format	hhsrptin08.xls	No	No	Paper Only
Form	1	09	hhsrptin09.xls	No	No	Paper Only
Form	1	short	hhsrptin10.xls	No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 144	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	144	144
Annual IC Time Burden (Hours)	144	144
Annual IC Cost Burden (Dollars)	6,192	6,192

Documents for IC

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.