Information Collection

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

IC 267382 under ICR 202405-0970-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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 496 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
496 Form CB-496: Title IV-E Programs Quarterly Financial Rep Form CB-496 FORM - Final Proposed Revision 02.27.20 Clean.xlsx	Form
496 Form CB-496: Title IV-E Programs Quarterly Financial Rep Form CB-496 FORM - Final Proposed Revision 02.27.20 Clean.xlsx	Form
CB-496 Mandatory Grant Submission Template 2.27.20.docx NonDiscretionary Financial Form GenIC - Form CB-496	IC Document
CB-496 Mandatory Grant Submission Template 2.27.20.docx NonDiscretionary Financial Form GenIC - Form 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	496	Form CB-496: Title IV-E Programs Quarterly Financial Report	Form CB-496 FORM - Final Proposed Revision 02.27.20 Clean.xlsx		Yes	Yes	Fillable Fileable
Instruction			Form CB 496 INSTRUCTIONS - 02.26.20.docx		Yes	Yes	Printable Only

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: Private Sector

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

Percentage of Respondents Reporting Electronically: 100 %

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
NonDiscretionary Financial Form GenIC - Form CB-496	CB-496 Mandatory Grant Submission Template 2.27.20.docx	05/01/2024

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