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LIHEAP Detailed Model Plan Application - FY24
Low Income Home Energy Assistance Program (LIHEAP) Detailed Model Plan Application
OMB: 0970-0075
IC ID: 211409
OMB.report
HHS/ACF
OMB 0970-0075
ICR 202402-0970-013
IC 211409
( )
Documents and Forms
Document Name
Document Type
2020 LIHEAP Detailed Model Plan Application.pdf
Other-Detailed Model Plan Applicatio
2020 LIHEAP Detailed Model Plan Application.pdf
Other-Detailed Model Plan Applicatio
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
LIHEAP Detailed Model Plan Application - FY24
Agency IC Tracking Number:
OCS
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
45 CFR 96.10
45 CFR 96.42
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Detailed Model Plan Application
2020 LIHEAP Detailed Model Plan Application.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
207
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
207
0
0
0
0
207
Annual IC Time Burden (Hours)
104
0
0
0
0
104
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
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.