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

Generic Clearance for Financial Reports used for ACF Non-Discretionary Grant Programs

Documents and Forms

Document Name Document Type
Form 496 Form CB-496: Title IV-E Programs Quarterly Financial Report Form
Form CB 496 INSTRUCTIONS_ Sept 19 2024.docx Instruction
496 Form CB-496: Title IV-E Programs Quarterly Financial Rep CB-496-Form Sept 19 2024.xlsx Form
NonDisc Grant GenIC Submission Form - CB-496 Sept 2024_fnl.docx NonDiscretionary Financial Form GenIC - Form CB-496 IC Document
14 Day FRN_CB-496 Change Req_Financial Forms GenIC_0970-0510_8.28.24.pdf 14-Day FRN - Comment period of changes Sept 2024 IC Document
Change Memo – CB-496 September 2024 Updates.docx Change Request Memo - CB-496, Sept 2024 IC Document

Information Collection (IC) Details

IC Title:	Form CB-496: Title IV-E Programs Quarterly Financial Report	Agency IC Tracking Number:	CB

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection 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	CB-496-Form Sept 19 2024.xlsx		Yes	Yes	Fillable Fileable
Instruction			Form CB 496 INSTRUCTIONS_ Sept 19 2024.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 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	268	0	268
Annual IC Time Burden (Hours)	6,154	-546	6,700
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
NonDiscretionary Financial Form GenIC - Form CB-496	NonDisc Grant GenIC Submission Form - CB-496 Sept 2024_fnl.docx	09/23/2024
14-Day FRN - Comment period of changes Sept 2024	14 Day FRN_CB-496 Change Req_Financial Forms GenIC_0970-0510_8.28.24.pdf	09/23/2024
Change Request Memo - CB-496, Sept 2024	Change Memo – CB-496 September 2024 Updates.docx	09/23/2024

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