Annual Report on State MOE Programs

Instructions for Annual Report on State Maintenance-of-Effort Programs: Form ACF-204

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0248 can be found here:

Documents and Forms

Document Name Document Type
Form 204 Annual Report on State MOE Programs Form and Instruction
204 ACF-204 TANF Annual Report Template Updated with EBT Requirements - edit 8.28.15.docx Form and Instruction
PI on electronic submission of annualrpt.doc Program Instruction IC Document

Information Collection (IC) Details

IC Title:	Annual Report on State MOE Programs	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 265

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	204	ACF-204	TANF Annual Report Template Updated with EBT Requirements - edit 8.28.15.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: 54	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	54	0	54
Annual IC Time Burden (Hours)	7,452	1,080	6,372
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Program Instruction	PI on electronic submission of annualrpt.doc	03/24/2009

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