Form 1 LIHWAP Forecast

								OMB #: 0970-0558 Expiration Date: 11/23/2023
Section I. Current Expenditures
CAA Award	CAA Award Spent	CAA Award Remaining	ARPA Award	ARPA Award Spent	ARPA Award Remaining	Total LIHWAP Amount Spent	Total Percent Spent as of [insert date]	Avg burn through rate per month	Total amount leftover at current rate
Section II. CAA Forecasted Expenditures (forecast the remaining portion of LIHWAP funding only)									CAA
January	February	March	April	May	June	July	August	September	Total
									$-
Section III. ARPA Forecasted Expenditures (forecast the remaining portion of LIHWAP funding only)									ARPA
January	February	March	April	May	June	July	August	September	Total
									$-
Remarks:
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to gain an understanding of the expenditure rate at which LIHWAP grant recipients intend to obligate the remining portions of their LIHWAP budget in order to forecast the potential for LIHWAP funds to be remain unobligated at the end of the currently authorized project period, September 30, 2023. The Office of Community Services will use this information to target training and technical assistance and to implement procedures that support the maximum amount of LIHWAP funding being spent on benefit payments for eligible households. Public reporting burden for this collection of information is estimated to average two hours per grantee, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection of information under the authority of the American Rescue Plan Act of 2021 and the Consolidated Appropriations Act of 2021. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0558 and the expiration date is 11/23/2023. If you have any comments on this collection of information, please contact Olivia Barfield, Program Specialist, olivia.barfield@acf.hhs.gov.