Information Collection

Form CB-496, "Title IV-E Program Quarterly Financial Report

IC 10037 under ICR 201306-0970-003 · OMB 0970-0205.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0205 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CB-496 Title IV-E Programs Quarterly Financial Report Form CB-496, "Title IV-E Program Quarterly Financial Report	Form
Form CB-496 Quarterly Financial Report Form CB-496, "Title IV-E Program Quarterly Financial Report	Form
Form CB-496 Instructions - DRAFT May 2013.doc	Instruction
CB-496 Title IV-E Programs Quarterly Financial Report Form CB-496 - DRAFT May 2013 - Parts 1 and 2.pdf	Form
CB-496 Quarterly Financial Report Form CB-496 - DRAFT May 2013 - Part 3.pdf	Form

IC Title:

Form CB-496, "Title IV-E Program Quarterly Financial Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CB-496	No	No	Fillable Printable
Form	CB-496	Yes	Yes	Fillable Printable
Instruction		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 62

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Previously Approved
Annual Number of Responses for this IC	248	0	248
Annual IC Time Burden (Hours)	4,960	744	4,216
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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