Information Collection

Annual Report on State MOE Programs

IC 10099 under ICR 201910-0970-009 · OMB 0970-0248.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ACF-204 Annual Report on State MOE Programs	Form
MOE204instr - 10.24.19.pdf	Instruction
ACF-204 Annual Report on State MOE Programs TANF Annual Report Form - 10.24.19.docx	Form

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 265.9(b)-(c)6

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	ACF-204	Annual Report on State MOE Programs	TANF Annual Report Form - 10.24.19.docx		Yes	Yes	Fillable Fileable
Instruction			MOE204instr - 10.24.19.pdf		Yes	Yes	Printable Only

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: 0 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	54	54
Annual IC Time Burden (Hours)	6,372	6,372
Annual IC Cost Burden (Dollars)	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.