Quarterly Performance and Management Report for LIHWAP

Low Income Household Water Assistance Program (LIHWAP) Reports

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0578 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Quarterly Performance and Management Report for LIHWAP Form
LIHWAP_Quarterly_Report_Instructions_Draft_10.14.21_IOAS OS Apprvd.docx Instruction
LIHWAP_Quarterly_Report_Instructions_Draft_10.14.21_IOAS OS Apprvd.docx Instruction
1 LIHWAP Quarterly Report LIHWAP Quarterly Report_FY21_10.14.21.xlsx Form
1 LIHWAP Quarterly Report LIHWAP Quarterly Report_FY21_10.14.21.xlsx Form

Information Collection (IC) Details

IC Title:	Quarterly Performance and Management Report for LIHWAP	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	LIHWAP Quarterly Report	LIHWAP Quarterly Report_FY21_10.14.21.xlsx		Yes	Yes	Fillable Fileable
Instruction			LIHWAP_Quarterly_Report_Instructions_Draft_10.14.21_IOAS OS Apprvd.docx		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: 157	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Farms

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	628	628
Annual IC Time Burden (Hours)	8,164	8,164
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.