OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

IV-E Foster Care and Adoption Assistance Quarterly Financial Report

ICR 201306-0970-003 · OMB 0970-0205 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form CB-496 Form CB-496, "Title IV-E Program Quarterly Financial Report Form Modified Available
Supporting Statement - Form CB-496 - 2013.doc Supporting Statement A Uploaded 2013-06-19 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
10037 Form CB-496, "Title IV-E Program Quarterly Financial Report Form Modified
ICR Details
0970-0205 201306-0970-003
Historical Active 201006-0970-001
HHS/ACF 19826
IV-E Foster Care and Adoption Assistance Quarterly Financial Report
Revision of a currently approved collection   No
Regular
Approved without change 08/27/2013
Retrieve Notice of Action (NOA) 06/24/2013
  Inventory as of this Action Requested Previously Approved
08/31/2016 36 Months From Approved 08/31/2013
248 0 248
4,960 0 4,216
0 0 0
This form is used by States (including DC and PR)and Tribes to report the Total and Federal share of program expenditures made during the preceding quarter and to report the estimated Total and Federal share of the same expenditures to be made in the upcoming quarter for the Foster Care, Adoption Assistance and Guardianship Assistance programs under Title IV-E of the Social Security Act. This information is used to calculate quarterly grant awards and the collected data is available to the general public. Respondents are limited to the designated Title IV-E agency in each State or Tribe.
PL: Pub.L. 110 - 351 101 Name of Law: Fostering Connections to Success and Increasing Adoptions Act of 2008
  
PL: Pub.L. 110 - 351 101 Name of Law: Fostering Connections to Success and Increasing Adoptions Act of 2008
Not associated with rulemaking
  77 FR 70165 11/23/2012
78 FR 36552 06/18/2013
Yes
1
IC Title Form No. Form Name
Form CB-496, "Title IV-E Program Quarterly Financial Report CB-496, CB-496 Title IV-E Programs Quarterly Financial Report ,   Quarterly Financial Report
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 248 248 0 0 0 0
Annual Time Burden (Hours) 4,960 4,216 744 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This form will be used by States (including DC and PR) and Tribes to report the Total and computed Federal share of the actual and estimated quarterly expenditures, including those associated with approved Demonstration Projects, and the number of children served in the operation of the Foster Care, Adoption Assistance and Guardianship Assistance programs under Title IV-E of the Social Security Act. This information is used to calculate quarterly grant awards and the collected data is available to the general public. Respondents are limited to the designated Title IV-E agencies in each State or Tribe with approved title IV-E plans.
$0
No
No
No
No
No
Uncollected
Robert Sargis 2026907275
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/24/2013