Information Collection

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

IC 246232 under ICR 202103-0970-006 · 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⚠️ Notice: This information collection may be referencing outdated material.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 Title IV-E Programs Quarterly Financial Report Form 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 Title IV-E Programs Quarterly Financial Report Form CB-496 FORM - Final Proposed Revision 02.27.20 Clean.xlsx	Form
CB-496 Title IV-E Programs Quarterly 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 CB-496 Mandatory Grant Submission Template	IC Document
CB-496 Mandatory Grant Submission Template 2.27.20.docx CB-496 Mandatory Grant Submission Template	IC Document
NonSub Change Request - CB 496 02.27.2020.docx NonSub Change Request - Family First Transition Act Reporting Reqs	IC Document
NonSub Change Request - CB 496 02.27.2020.docx NonSub Change Request - Family First Transition Act Reporting Reqs	IC Document
NOA - NonSub Change CB-496_GenIC Financial Reports_0970-0510_3.9.20.pdf NOA - CB - 496	IC Document
NOA - NonSub Change CB-496_GenIC Financial Reports_0970-0510_3.9.20.pdf NOA - CB - 496	IC Document

IC Title:

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

Agency IC Tracking Number:

IC Status: New

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				Yes	Yes	Fillable Fileable
Instruction					Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 67

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
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
CB-496 Mandatory Grant Submission Template		03/12/2021
NonSub Change Request - Family First Transition Act Reporting Reqs		03/12/2021
NOA - CB - 496		03/12/2021

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

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