LIHEAP Detailed Model Plan Application

Low Income Home Energy Assistance Program (LIHEAP) Detailed Model Plan Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0075 can be found here:

Documents and Forms

Document Name Document Type
2020 LIHEAP Detailed Model Plan Application.pdf Other-Detailed Model Plan Applicatio

Information Collection (IC) Details

IC Title:	LIHEAP Detailed Model Plan Application	Agency IC Tracking Number:	OCS

Is this a Common Form? No		IC Status: Modified

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

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 210	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	210	210
Annual IC Time Burden (Hours)	105	105
Annual IC Cost Burden (Dollars)	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.