Form ACF-696 Financal Report

Child Care and Development Fund Quarterly Financial Report

ACF-696 with ARRA.xls

Child Care and Development Fund Quarterly Financial Report

OMB: 0970-0163

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U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES -- ADMINISTRATION FOR CHILDREN AND FAMILIES


CHILD CARE AND DEVELOPMENT FUND ACF-696 FINANCIAL REPORT
STATE

FISCAL YEAR 2009
SUBMISSION (MARK ONE BOX) CURRENT QTR. ENDED: NEXT QTR. BEGINNING:





ORIGINAL [ ] REVISED [ ]



GRANT DOCUMENT #
FINAL [ ]









CUMULATIVE FISCAL YEAR TOTALS



(COLUMN A) (COLUMN B) (COLUMN C) (COLUMN D) (COLUMN E)



MANDATORY FUNDS MATCHING FUNDS DISCRETIONARY FUNDS MOE ARRA (American Recovery



(Federal Share Only) AT FMAP RATE OF _____% (excluding ARRA) (State Share Only) and Reinvestment Act Funds




(Federal and State Share) (Federal Share Only)
(Federal Share Only)
1. TOTAL

$ $ $ $ $

1(a). CHILD CARE ADMINISTRATION
$ $ $ $ $

1(b). QUALITY ACTIVITIES EXCLUDING TARGETED FUNDS
$ $ $ $ $

1(c). INFANT AND TODDLER TARGETED FUNDS*


$
$

1(d). QUALITY EXPANSION TARGETED FUNDS*


$
$

1(e). SCHOOL-AGE/RESOURCE AND REFERRAL TARGETED FUNDS*


$


1(f). OTHER TARGETED FUNDS


$


1(g). DIRECT SERVICES
$ $ $ $ $

1(h). NONDIRECT SERVICES
$ $ $ $ $


1(h)(1). SYSTEMS $ $ $ $ $


1(h)(2). CERTIFICATE PROGRAM COSTS/ELIG. DETERMINATION $ $ $ $ $


1(h)(3). ALL OTHER NONDIRECT SERVICES $ $ $ $ $
2. STATE SHARE OF EXPENDITURES




$

2(a). REGULAR



$

2(b). PRIVATE DONATED FUNDS



$

2(c). PRE-K



$
3. FEDERAL SHARE OF EXPENDITURES

$ $ $
$
4. FEDERAL SHARE OF UNLIQUIDATED OBLIGATIONS

$ $ $
$
5. AWARDED

$ $ $
$
6. TRANSFER FROM TANF



$

7. UNOBLIGATED BALANCE

$ $ $
$
8. FEDERAL FUNDS REQUESTED

$ $ $
$

ESTIMATES FOR NEXT QTR. (Refer to Next Qtr. Beginning Date Above.)

9. ESTIMATED CHILD SERVICE MONTHS FUNDED BY ARRA:
(See page 8 of instructions)




#
PLEASE REFER TO REALLOTTED FUNDS INFORMATION ON PAGES 5 OF THE INSTRUCTIONS.







9/30 SUBMITTAL -- IF AVAILABLE, DOES THE STATE REQUEST REALLOTTED MATCHING FUNDS? YES [ ] NO [ ]. IF YES AND THE STATE REQUESTS A LIMIT TO THE MATCHING

AMOUNT, PLEASE ENTER AMOUNT $ _______________






3/31 SUBMITTAL -- IF AVAILABLE, DOES THE STATE REQUEST REALLOTTED DISCRETIONARY FUNDS? YES [ ] NO [ ].





THIS IS TO CERTIFY THAT THE INFORMATION REPORTED ON ALL PARTS OF THIS FORM IS ACCURATE AND TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF.
THIS ALSO CERTIFIES THAT THE STATE'S SHARE OF ESTIMATES IS OR WILL BE AVAILABLE TO MEET THE NONFEDERAL SHARE OF EXPENDITURES AS REQUIRED BY LAW.
SIGNATURE: STATE OFFICIAL

DATE SUBMITTED: TYPED NAME, TITLE, AGENCY NAME, PHONE #
APPROVED OMB CONTROL NO. 0970-0163






EXPIRATION DATE: 6/30/2010
FORM ACF-696 PAGE 1 OF 1






* TARGETED FUNDS NARRATIVE REPORT ATTACHMENT: FOR LINES 1(c), 1(d), 1(e) IN COLUMN C AND COLUMN E, ATTACH A SEPARATE PAGE THAT INCLUDES A BRIEF DESCRIPTION OF THE ACTIVITIES ON WHICH TARGETED FUNDS, FROM THE FISCAL YEAR'S GRANT, WERE EXPENDED. THIS NEED ONLY BE COMPLETED WITH EACH 4TH QUARTER'S REPORT.
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File Modified2009-06-04
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