Information Collection

Annual Report on TANF and State MOE Programs – ACF-204 (Annual TANF and MOE Report) §265.9(b)-(c)6

IC 10099 under ICR 202603-0970-007 · OMB 0970-0248.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ACF-204 Annual TANF Report on State MOE Programs Annual Report on TANF and State MOE Programs – ACF-204 (Annual TANF and MOE Report) §265.9(b)-(c)6	Form and Instruction
MOE ACF-204 Instructions -clean.docx	Instruction
ACF-204 Annual TANF Report on State MOE Programs Annual TANF and MOE Report Form_clean2.docx	Form and Instruction

IC Title:

Annual Report on TANF and State MOE Programs â ACF-204 (Annual TANF and MOE Report) §265.9(b)-(c)6

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 265.9(b)-(c)6

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 and Instruction	ACF-204				Yes	Yes	Fillable Fileable
Instruction					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: 54

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
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	54	0	54
Annual IC Time Burden (Hours)	4,320	-2,052	6,372
Annual IC Cost Burden (Dollars)	0	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.

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