Form ACF-696 CCDF ACF-696 Financial Report

CHILD CARE AND DEVELOPMENT FUND ACF-696 FINANCIAL REPORT
State or Territory	Grant Year		Final Report [ ] Yes [ ] No			Current Quarter Ended
	Grant Number:					Next Quarter Beginning
Cumulative Fiscal Year Totals
	(COLUMN A) MANDATORY FUNDS Grant Document #s CCDF (states) CCDT (territories)	(COLUMN B) MATCHING FUNDS AT FMAP RATE OF ____% (Federal and State Shares) Grant Document # CCDM	(COLUMN C) DISCRETIONARY FUNDS Grant Document # CCDD	(COLUMN D) MOE	(COLUMN E) DISCRETIONARY DISASTER RELIEF FUNDS GrantDocument # CCDX	(COLUMN F) DISCRETIONARY DISASTER RELIEF FUNDS CONST. & MAJOR RENOVATION Grant Document # CCDY	(COLUMN G) DISCRETIONARY CARES ACT FUNDS Grant Document # CCC3	(COLUMN H) DISCRETIONARY CRRSA ACT FUNDS Grant Document # CCC5	(COLUMN I) SUPPLEMENTAL DISCRETIONARY ARP ACT FUNDS Grant Document # CDC6	(COLUMN J) STABILZATION ARP ACT FUNDS Grant Document # CSC6
1. Total Expenditures
1(a). Child Care Administration
1(b). Quality Activities Excluding Infant/Toddler Quality Activities Reported On Line 1(c)
1(c). Infant/Toddler Quality Activities
1(d). Direct Services
1(e). Non - Direct Services
1(e)(1). Systems
1(e)(2). Certificate Program Costs/Eligibility Determination
1(e)(3). All Other Non-Direct Services
1(f). Construction and Major Renovation
2. State Share of Expenditures
2(a). Regular
2(b). Private Donated Funds
2(c). Pre - K
3. ARP Act Stabilization Subgrants to Providers
4. ARP Act Stabilization Set Aside (Admin & TA)
4(a) Subgrant administration
4(b) Systems
4(c) TA - application
4(d) TA - implementation
4(e) Publicity
4(f) Activities to build supply
5. Federal Share of Expenditures
6. Federal Share of Unliquidated Obligations
7. Awarded
8. Transfer From TANF
9. Unobligated Balance
9(a). Was the State or Territory unable to obligate at least 50% of the CCDF stabilization grants by December 11, 2021?										YES [ ] NO [ ]
10. Federal Funds Requested : Estimates For Next Quarter (Refer to Next Quarter Beginning Date Above.)
Please refer to redistribution and reallotment of funds information information in the instructions.
11. Redistributed Funds (September 30 Submittal): If available, does the State or Territory request redistributed funds? [Mandatory (territories, per ARP Act); Matching (states)]	YES [ ] NO [ ]	YES [ ] NO [ ]
11(a). If yes, does the State or Territory request a limit to the redistributed funds received?	0.00	0.00
12. Reallotted Funds: If available, does the State request reallotted discretionary or stabilization funds?			YES [ ] NO [ ]				YES [ ] NO [ ]	YES [ ] NO [ ]	YES [ ] NO [ ]	YES [ ] NO [ ]
Signature Information
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 States share
of Estimates is or will be Available to meet the NON-FEDERAL Share of Expenditures as Required by Law.
Signature: State Official	Typed Name, Title, Agency Name, Phone #:
Date Certified:	Submit Date:
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