Cert of Maintenance Effort

Certification of Maintenance of Effort

CERTIFICATION OF STATE RESOUCES EXPENDED, UNDER TITLE III OF THE OLDER AMERICANS ACT OF 1965, AS AMENDED, TO MEET THE REQUIRED LEVEL OF MAINTENANCE OF EFFORT DURING

FISCAL YEAR:

STATE:

I, the undersigned, certify that the State resources expended to meet the maintenance of effort requirement set forth by Title III of the Older Americans Act, under the approved State plan, for the period of October 1, , through September 30, were $ .

This amount is (check one):

Less than the required level of maintenance of effort
Equal to the required level of maintenance of effort
More than the required level of maintenance of effort

Signature of Authorized State Official

Date

Paperwork Reduction Act Public Burden Statement:

According to the Paperwork Reduction Act of 1995 5 CFR § 1320.8(b)(3), no persons are required to respond to a collection of information unless such collection displays a valid OMB control number (OMB 0985-0009). Public reporting burden for this collection of information is estimated to average one (1) hour per response, including time for gathering, maintaining the data needed, completing, and reviewing the collection of information. The obligation to respond to this collection is required to retain or maintain benefits under the Older Americans Act (P.L. 116-131). Information collected is planned for use by ACL to conduct federal oversight of Aging Programs. ACL uses information collected to monitor federal funds. Data will be kept private to the extent allowed by law. There are no assurances of confidentiality.