Annual Report on Children in Foster Homes and Children in Families Receiving Payment in Excess of the Poverty Income Level from a State Program Funded Under Part A of Title IV o (ACF-4125)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form ACF 4125 Annual Report on Children in Foster Homes and in Families Receiving Payments in Excess of the Poverty Income Level from a State Program	Form	Modified	Repair queued
Supporting Statement_ACF-4125_2.4.21.docx	Supporting Statement A	Uploaded 2021-03-11	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9787	Annual Report on Children in Foster Homes and in Families Receiving Payments in Excess of the Poverty Income Level from a State Program	Form	Modified

ICR Details

OMB Control No: 0970-0004	ICR Reference No: 202103-0970-005
Status: Received in OIRA	Previous ICR Reference No: 201712-0970-003
Agency/Subagency: HHS/ACF	Agency Tracking No: OFA
Title: Annual Report on Children in Foster Homes and Children in Families Receiving Payment in Excess of the Poverty Income Level from a State Program Funded Under Part A of Title IV o (ACF-4125)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/16/2021

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2021
Responses	52	52
Time Burden (Hours)	13,746	13,746
Cost Burden (Dollars)	0	0

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Abstract: The Elementary and Secondary Education Act of 1965 (ESEA), Section 1124 of Title I, as amended by P.L. 114-95, requires the Secretary of Health and Human Services (HHS) to determine the number of children aged five to seventeen, inclusive, that (1) are being supported in foster homes with public funds; or (2) are from families receiving assistance payments in excess of the current poverty income level for a family of four. The Administration for Children and Families (ACF) within HHS passes this information to the Secretary of Education for purposes of allocating grants authorized under this law. The statute requires that the formula to allocate these grants and distribute funds be based, in part, on October caseload data of the number of children in foster care or in families receiving payments from state programs funded under Title IV-A of the Social Security Act [Temporary Assistance for Needy Families (TANF)]. Both the TANF and foster care programs fall under the purview of ACF within HHS. The purpose of this annual data report is to provide annually updated data so that funds may be allocated in accordance with the ESEA.

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Authorizing Statute(s): PL: Pub.L. 104 - 193 110(j) Name of Law: Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA)
   PL: Pub.L. 107 - 110 1124(c)(4) Name of Law: No Child Left Behind Act of 2001
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 83585	12/22/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 14431	03/16/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Annual Report on Children in Foster Homes and in Families Receiving Payments in Excess of the Poverty Income Level from a State Program	ACF 4125	Annual Report on Children in Foster Homes and in Families Receiving Payments in Excess of the Poverty Income Level from a State Program

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	52	52	0	0	0	0
Annual Time Burden (Hours)	13,746	13,746	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $8,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/16/2021

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