Information Collection

Acf-196r

IC 210064 under ICR 201401-0970-002 · OMB 0970-0446.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0446 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 196 ACF-196R	Form
196 Quarterly Financial Report 196R Forms (FR2).xls	Form
Revised ACF-196R Instructions (FR2) Final.doc Instructions	IC Document

IC Title:

ACF-196R

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 45 CFR 265.3 through 265.9

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	196	Quarterly Financial Report	196R Forms (FR2).xls		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 51

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	204	204
Annual IC Time Burden (Hours)	6,528	6,528
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Instructions	Revised ACF-196R Instructions (FR2) Final.doc	01/15/2014

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