Form ACF-696T CCDF ACF-696T Financial Report for Tribal Grantees

Generic Clearance for Financial Reports

Copy of ACF 696T Form Revised for CRRSA Clean Version.xlsx

Child Care and Development Fund (CCDF) ACF-696T Financial Report for Tribal Grantees

OMB: 0970-0510

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CHILD CARE AND DEVELOPMENT FUND ACF-696T FINANCIAL REPORT










Tribe:
Grant Year (FFY grant was awarded):

GDN:


Final Report:
[ ] Yes
[ ] No





Expenditure Period: 10/1/______
TO 9/30/_______







Cumulative Fiscal Year Totals











COLUMN (A)
MANDATORY


Grant Document # CCDF
COLUMN (B)
DISCRETIONARY
(Not including Base)

Grant Document #
CCDD
COLUMN (C)
DISCRETIONARY

Base Amount

Grant Document #
CCDD
COLUMN (D) CONST. & MAJOR RENOVATION
MANDATORY

Grant Document #
CONT
COLUMN (E) CONST. & MAJOR RENOVATION
DISCRETIONARY

Grant Document # CONT
COLUMN (F)
DISCRETIONARY
DISASTER RELIEF FUNDS

Grant Document #
CCDX
COLUMN (G)
DISCRETIONARY
DISASTER RELIEF FUNDS
CONST. & MAJOR RENOVATION
Grant Document #
CCDY
Column (H)
DISCRETIONARY
CARES ACT FUNDS


Grant Document #
CCC3
Column (I)
DISCRETIONARY
CARES ACT FUNDS
CONST. & MAJOR RENOVATION
Grant Document #
CYC3
Column (J) DISCRETIONARY
CRRSA FUNDS


Grant Document #
CCC5
Column (K)
DISCRETIONARY
CRRSA FUNDS
CONST. & MAJOR RENOVATION
Grant Document #
CYC5
1. Federal Funds Awarded










2. Transfer to Constructions / Renovation










3. Total Funds Available










4. Expenditures for Direct Child Care Services










5. Expenditures for Child Care Administration










6. Expenditures for Non-Direct Services










7. Expenditures for Quality Activites (excluding infant and toddler quality activites reported on line 8)










8. Expenditures for Infant/Toddler Quality Activities










9. Expenditures for Construction / Major Renovation










10. Total Federal Expenditures










11. Total Federal Unliquidated obligations










12. Total Federal Unobligated balance










Reallotted Funds










Please refer to reallotted funds information in the instructions. 










If available, does the Tribe request reallotted discretionary funds?










[ ] YES










[ ] NO










IF THIS REPORT IS NOT RECEIVED WITHIN 90 DAYS AFTER THE END OF THE FISCAL YEAR IN WHICH THE GRANT WAS AWARDED (12/29), THE TRIBE WILL NOT BE ELIGIBLE FOR REALLOTMENT.










Signatures










This is to certify that the information reported on all parts of this form is accurate and true to the best of my knowledge and belief.










This also certifies that the tribal lead agency has expended required funds in accordance with CCDF regulation.










Signature: Tribal Official
Typed Name:
Title:
Agency Name:










[Threaded comment] Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924 Comment: Grantee e-signatures are as of the "certified" date. OLDC auto-inputs the report submissio date. Date Certified:
Phone #:










FORM ACF - 696T
APPROVED OMB CONTROL NO. 0970-0510
EXPIRATION DATE: 05/31/2021
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13): Public reporting burden for this collection of information is estimated to average 7 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.
Submit Date:










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