Generic Clearance for Financial Reports

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form ACF-696T CCDF ACF-696T Financial Report for Tribal Grantees	Form	New	Available
Form ACF-696 CCDF ACF-696 Financial Report for States and Territories	Form	New	Available
Form CB-496 CB Financial Report	Form	New	Available
Form 396 OCSE-396	Form	New	Available
Form 34 OCSE-34	Form	New	Available
MB-SS Generic Mand.docx	Supporting Statement A	Uploaded 2018-02-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
238356	Child Care and Development Fund (CCDF) ACF-696T Financial Report for Tribal Grantees	Form	New	CCDF ACF-696T Financial Report for Tribal Grantees
238356	Child Care and Development Fund (CCDF) ACF-696T Financial Report for Tribal Grantees	Instruction	New
238355	Child Care and Development Fund (CCDF) ACF-696 Financial Report for States and Territories	Form	New	CCDF ACF-696 Financial Report for States and Territories
238355	Child Care and Development Fund (CCDF) ACF-696 Financial Report for States and Territories	Instruction	New
233528	CB-496 - Title IV-E Programs Quarterly Financial Report	Form	New	CB Financial Report
233528	CB-496 - Title IV-E Programs Quarterly Financial Report	Instruction	New
231908	Child Support Engorcement Program Financial Reporting Forms	Form	New	OCSE-396
231908	Child Support Engorcement Program Financial Reporting Forms	Form	New	OCSE-34
231908	Child Support Engorcement Program Financial Reporting Forms	Instruction	New

ICR Details

OMB Control No: 0970-0510	ICR Reference No: 201802-0970-012
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Generic Clearance for Financial Reports
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/18/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/28/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2021	36 Months From Approved
Responses	1,000	0	0
Time Burden (Hours)	40,000	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: These tailored reports will be used for to meet the requirement for financial reports used in ACF mandatory grant programs.

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 58613	12/19/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 8484	02/27/2018
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
CB-496 - Title IV-E Programs Quarterly Financial Report	CB-496	CB Financial Report
Child Care and Development Fund (CCDF) ACF-696 Financial Report for States and Territories	ACF-696	CCDF ACF-696 Financial Report for States and Territories
Child Care and Development Fund (CCDF) ACF-696T Financial Report for Tribal Grantees	ACF-696T	CCDF ACF-696T Financial Report for Tribal Grantees
Child Support Engorcement Program Financial Reporting Forms	34, 396	OCSE-34 ,   OCSE-396

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,000	0	0	1,000	0	0
Annual Time Burden (Hours)	40,000	0	0	40,000	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: New ICR

---

Annual Cost to Federal Government: $400,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/28/2018

---