Information Collection

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

IC 10037 under ICR 201507-0970-008 · OMB 0970-0205.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CB-496 Form CB-496, "Title IV-E Program Quarterly Financial Report	Form
Instructions CB-496 DRAFT July 2015.docx	Instruction
CB-496 Quarterly Financial Report CB-496 DRAFT Parts 1-2-3-4 July 2015.pdf	Form

IC Title:

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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CB-496	Quarterly Financial Report	CB-496 DRAFT Parts 1-2-3-4 July 2015.pdf		Yes	Yes	Fillable Printable
Instruction			Instructions CB-496 DRAFT July 2015.docx		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: 67

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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	268	20	248
Annual IC Time Burden (Hours)	5,628	668	4,960
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.