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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.