ACF-204 CRC Part II

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Overview

Calculation Worksheet
2-Parent Calculation Worksheet
Impact template
Sample impact table
Excess MOE Worksheet

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Sheet 1: Calculation Worksheet

State?			Fiscal Year to which credit applies:
			Date of Completion:
PART 2 – Estimate of Caseload Reduction Credit
Impact of All Changes			Caseload Reduction Calculation
			FY 2005 TANF Caseload
			FY 2005 SSP Caseload
			Total FY 2005 Caseload	0
			FY TANF Caseload
			FY SSP Caseload
			Total FY Caseload	0
			Excess MOE Cases in FY	0
			Adjusted FY Caseload	0
			Caseload Decline	0	0.0%
			Decline – Net Impact	0
				Caseload Reduction Credit =	0.0%
Net Impact	0

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Sheet 2: 2-Parent Calculation Worksheet

			Fiscal Year to which credit applies:
			Date of Completion:
PART 2 – Estimate of Caseload Reduction Credit -- 2-Parent Caseload
Impact of All Changes			Caseload Reduction Calculation
			FY 2005 TANF 2-Parent Caseload
			FY 2005 SSP 2-Parent Caseload
			Total FY 2005 Caseload	0
			FY TANF 2-Parent Caseload
			FY SSP 2-Parent Caseload
			Total FY 2-Parent Caseload	0
			Excess MOE 2-Parent Cases in FY	0
			Adjusted FY Caseload	0
			Caseload Decline	0	0.0%
			Decline – Net Impact	0
				2-Parent Caseload Reduction Credit =	0.0%
Net Impact	0

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Sheet 3: Impact template

Policy Name

Date of Completion:

Impact on Each Month in FY ?

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Time of Closure

Prior years carryover

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Grand

Total

Total

0

0

0

0

0

0

0

0

0

0

0

0

0

FY ? monthly average

0

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Sheet 4: Sample impact table

Columbia
Impact #3, Full Family Sanction
											Date of Completion:	12/15/2008
	Impact on Each Month in FY 2007
	Oct	Nov	Dec	Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep
Time of Closure
Prior years carryover	-81	-76	-72	-69	-67	-65	-63	-61	-60	-59	-57	-56
Oct	-33	-30	-28	-26	-24	-21	-18	-16	-15	-13	-10	-8
Nov		-42	-39	-36	-34	-32	-29	-27	-25	-23	-21	-20
Dec			-55	-53	-51	-48	-46	-43	-41	-40	-38	-37
Jan				-64	-61	-59	-56	-53	-52	-51	-49	-47
Feb					-27	-25	-25	-24	-24	-24	-22	-21
Mar						-22	-20	-20	-20	-19	-18	-18
Apr							-16	-16	-12	-11	-11	-11
May								-26	-23	-21	-21	-19
Jun									-24	-20	-18	-17
Jul										-31	-26	-26
Aug											-29	-23
Sep												-26	Grand
													Total
Total	-114	-148	-194	-248	-264	-272	-273	-286	-296	-312	-320	-329	-3,056
												FY 2007 monthly average	-255

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Sheet 5: Excess MOE Worksheet

				Fiscal Year to which credit applies:
				Date of Completion:
Excess MOE Calculation Worksheet
Caseload Data			Expenditure Data
FY 2005 TANF Caseload	0		Total Expenditures
FY 2005 SSP Caseload	0		FY Total Federal Expenditures
Total FY 2005 Caseload	0		FY Total MOE Expenditures
FY TANF Caseload	0		Total Expenditures (Federal + MOE)		$0
FY SSP Caseload	0
Total FY Caseload	0		Assistance Expenditures
			FY Federal Expenditures on Assistance
2-Parent Caseload Data			FY MOE Expenditures on Assistance
FY 2005 2-p TANF Caseload	0		Total Expenditures on Assistance (Federal + MOE)		$0
FY 2005 2-p SSP Caseload	0		Percentage of Expenditures on Assistance		0.00%
Total FY 2005 Caseload	0
FY 2-p TANF Caseload	0		Expenditures Per Case
FY 2-p SSP Caseload	0		Average Expenditures per Case		$0
Total FY Caseload	0		Average Expenditures per Case on Assistance		$0
			MOE and Excess MOE
			Required MOE (80% or 75%)
			Excess MOE Expenditures		$0
			Excess MOE Expenditures on Assistance		$0
Adjusted Caseload Data
Adjusted FY Overall Caseload	0		Assistance Cases Funded by Excess MOE		0
Adjusted FY 2-parent Caseload	0		2-Parent Assistance Cases Funded by Excess MOE		0