Information Collection

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

IC 233528 under ICR 202102-0970-011 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Form CB 496 INSTRUCTIONS - 02.26.20.docx	Instruction
Form CB 496 INSTRUCTIONS - 02.26.20.docx	Instruction
CB-496 CB Financial Report Form CB-496 FORM - Final Proposed Revision 02.27.20 Clean.xlsx	Form
CB-496 CB Financial Report Form CB-496 FORM - Final Proposed Revision 02.27.20 Clean.xlsx	Form
CB-496 Mandatory Grant Submission Template 2.27.20.docx Submission Form Template - Updated Burden Feb 2020	IC Document
CB-496 Mandatory Grant Submission Template 2.27.20.docx Submission Form Template - Updated Burden Feb 2020	IC Document
NonSub Change Request - CB 496 02.27.2020.docx NonSub Change Memo - CB 496	IC Document
NonSub Change Request - CB 496 02.27.2020.docx NonSub Change Memo - CB 496	IC Document

IC Title:

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

Agency IC Tracking Number:

IC Status: Unchanged

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	Form CB-496 FORM - Final Proposed Revision 02.27.20 Clean.xlsx		Yes	Yes	Fillable Printable
Instruction			Form CB 496 INSTRUCTIONS - 02.26.20.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
	Requested	Previously Approved
Annual Number of Responses for this IC	268	268
Annual IC Time Burden (Hours)	6,700	6,700
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Submission Form Template - Updated Burden Feb 2020	CB-496 Mandatory Grant Submission Template 2.27.20.docx	02/27/2020
NonSub Change Memo - CB 496	NonSub Change Request - CB 496 02.27.2020.docx	02/27/2020

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