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["OMB Control No. 0970-0060","LIHEAP Household Report--Federal Fiscal Year 2009--Short Format",null,null," Expiration Date:     "]
[]
["Grantee Name:",null,null,"Date:"]
["Contact Person:",null,null,"Phone:"]
[]
["The LIHEAP Household Report-Short Format is for use by all direct-grant Indian tribes and tribal organizations.  The LIHEAP Household Report-Short Format"]
["also is for use by insular areas with annual LIHEAP allotments of less than $200,000.  This report provides data on LIHEAP assisted households for Federal "]
["Fiscal Year (FFY) 2009, the period of October 1, 2008 - September  30, 2009.  The Report consists of the Recommended Short Format for Assisted Households  "]
["below.  As the reported data are aggregated, the information in this report is not considered to be confidential."]
[]
["Both the Recommended Short Format (the Excel file name is hhsrptin.xls) and the instructions on completing the LIHEAP Household Report-Short Format "]
["(the Word file name is hhrptins.doc) can be downloaded at the Forms section of the Office of Community Services LIHEAP web site at:  "]
["http://www.acf.dhhs.gov/programs/liheap/grantee_forms/index.html#household_report"]
[]
["The spreadsheet is page protected in order to keep the format uniform.  The items requiring a response are not page protected.  However, other areas of the "]
["spreadsheet can not be modified. "]
[]
[null,"RECOMMENDED SHORT FORMAT FOR LIHEAP ASSISTED HOUSEHOLDS ",{"$nulls":8}," "]
[]
[null,"REQUIRED DATA"]
[null,"Type ","Number of"]
[null,"of","assisted"]
[null,"assistance","households"]
[null,"Heating"]
[null,"Cooling"]
[null,"Winter/year round crisis"]
[null,"Summer crisis"]
[null,"Weatherization"]
[]
["Note:  Include any notes below for (indicate which type of assistance the note is referencing)."]