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pdfTANF DATA REPORT - SECTION 3
TANF AGGREGATED DATA COLLECTION FOR FAMILIES RECEIVING ASSISTANCE UNDER
THE TANF PROGRAM
GENERAL INFORMATION
2.
1.
State FIPS Code
Tribal Code
(For Tribal Use Only)
3.
Calendar Quarter
Year
Y
Quarter
Y
Y
Y
Q
TANF APPLICATIONS
FIRST MONTH
4.
Total Number of Applications
5.
Total Number of Approved Applications
6.
Total Number of Denied Applications
SECOND MONTH
THIRD MONTH
FAMILIES RECEIVING ASSISTANCE
FIRST MONTH
7.
THIRD MONTH
Total Amount of Assistance
$
8.
SECOND MONTH
$
$
Total Number of Families
OMB Number 0970-0199 - Expiration Date: 06/30/2002
ACF - 199
TANF DATA REPORT - SECTION 3
Page 1
9.
Total Number of Two-Parent Families
10.
Total Number of One-Parent Families
11.
Total Number of No-Parent Families
12.
Total Number of Recipients
13.
Total Number of Adult Recipients
14.
Total Number of Child Recipients
15.
Total Number of Non-Custodial Parents Participating in Work Activities
16.
Total Number of Births
17.
Total Number of Out-of-Wedlock Births
FAMILIES NO LONGER RECEIVING ASSISTANCE
FIRST MONTH
18.
SECOND MONTH
THIRD MONTH
Total Number of Closed Cases
OMB Number 0970-0199 - Expiration Date: 06/30/2002
ACF - 199
TANF DATA REPORT - SECTION 3
Page 2
| File Type | application/pdf |
| File Title | Microsoft Word - tanrpt3f.doc |
| Author | ACF |
| File Modified | 2006-06-13 |
| File Created | 2006-06-13 |