View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Low Income Household Water Assistance Program (LIHWAP) Program Development	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			ADMIN_LIHWAP_Draft Input Survey_03192021_FINAL.docx		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: 220	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	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	220	0	220	0	0	0
Annual IC Time Burden (Hours)	110	0	110	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement - Formative GenIC for Program Support: LIHWAP Program Development Survey	ADMIN_LIHWAP_Draft Survey Supporting Statement A_03112021_FINAL.docx	03/19/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.