Information Collection

CB-496 - Title IV-E Programs Quarterly Financial Report

IC 233528 under ICR 201802-0970-012 · OMB 0970-0510.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0510 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CB-496 CB-496 - Title IV-E Programs Quarterly Financial Report	Form
DRAFT Final CB 496 INSTRUCTIONS - Clean 10-10-18.docx	Instruction
CB-496 CB Financial Report DRAFT Final CB-496 FORM Clean - 10-10-18.xlsx	Form
CB-496 Mandatory Grant Submission Template 10-10-18.doc justification	IC Document

IC Title:

CB-496 - Title IV-E Programs Quarterly Financial Report

Agency IC Tracking Number:

IC Status: New

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	CB Financial Report	DRAFT Final CB-496 FORM Clean - 10-10-18.xlsx		Yes	Yes	Fillable Printable
Instruction			DRAFT Final CB 496 INSTRUCTIONS - Clean 10-10-18.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: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	268	268
Annual IC Time Burden (Hours)	6,432	6,432
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
justification	CB-496 Mandatory Grant Submission Template 10-10-18.doc	10/15/2018

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