Information Collection

Acf-196r

IC 210064 under ICR 202312-0970-010 · OMB 0970-0446.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 196R ACF-196R	Form
ACF_196R_Instructions_FINAL Feb 2024 _ Clean Version.docx	Instruction
ACF_196R_Instructions_FINAL Feb 2024 _ Clean Version.docx	Instruction
196R ACF-196R Form ACF_196R_form - TANF - Feb 2024.xlsx	Form
196R ACF-196R Form ACF_196R_form - TANF - Feb 2024.xlsx	Form

IC Title:

ACF-196R

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 265

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	196R	ACF-196R Form	ACF_196R_form - TANF - Feb 2024.xlsx		Yes	Yes	Fillable Fileable
Instruction			ACF_196R_Instructions_FINAL Feb 2024 _ Clean Version.docx		Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 51

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
	Approved	Previously Approved
Annual Number of Responses for this IC	204	204
Annual IC Time Burden (Hours)	2,856	2,856
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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