Instructions for Annual Report on State Maintenance-of-Effort Programs: Form ACF-204

Forms and Documents

Document Name	Status
Form ACF-204 Annual Report on State MOE Programs Form	Modified
PI on electronic submission of annualrpt.doc Supplementary Document	2009-03-24
Supporting Statement ACF-204.doc Supporting Statement A	2009-03-24

IC Document Collections

IC ID	Document Title	Status
188632	OLDC Sytem-Maintenance Instruction	New
10099	Annual Report on State MOE Programs Form	Modified

ICR Details

OMB Control No: 0970-0248	ICR Reference No: 200904-0970-001
Status: Historical Active	Previous ICR Reference No: 200701-0970-005
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Instructions for Annual Report on State Maintenance-of-Effort Programs: Form ACF-204
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/29/2009
	Date Received in OIRA: 04/01/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2012	36 Months From Approved	05/31/2009
Responses	162	0	54
Time Burden (Hours)	6,386	0	6,912
Cost Burden (Dollars)	0	0	0

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Abstract: The report is used to collect descriptive program characteristics information on the programs operated by States and Territories in association with their Temporary Assistance for Needy Families (TANF) programs. All State and Territory expenditures claimed toward States and Territories MOE requirements must be appropriate, i.e., meet all applicable MOE requirements. The Annual MOE Report provides the ability to learn about and to monitor the nature of State and Territory expenditures used to meet States and Territories MOE requirements, and it is an important source of information about the different ways that States and Territories are using their resources to help families attain and maintain self-sufficiency. In addition, the report is used to obtain State and Territory program characteristics for ACFs annual report to Congress, and the report serves as a useful resource to use in Congressional hearings about how TANF programs are evolving, in assessing State and Territory MOE expenditures, and in assessing the need for legislative changes.

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Authorizing Statute(s): US Code: 42 USC 611 Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 60297	10/10/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 12364	03/24/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Annual Report on State MOE Programs	ACF-204	Annual Report on State MOE Programs
OLDC Sytem-Maintenance

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ICR Summary of Burden

	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	162	54	0	108	0	0
Annual Time Burden (Hours)	6,386	6,912	0	-526	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Using Information Technology

Short Statement: There is reduction in burden on respondents of 9.75 hours per respondent for a total reduction from 6,912 hours to 6,385.5 hours. The estimated 9.75 hours per respondent is due to no longer having to prepare submissions in hard copy format in order for routing via the desk-to-desk method. The report will now be routed electronically to all appropriate parties, therefore saving time in the clearance process. This is a program change due to the addition of the OLDC system updates and instructions which allows for electronic submission and an overall reduction in burden.

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Annual Cost to Federal Government: $24,300

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 04/01/2009

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