Child Care and Development Fund Quarterly Financial Report (ACF-696)

Forms and Documents

Document Name	Status
Form ACF-696 Child Care and Development Fund Quarterly Financial Report Form and Instruction	Modified
ACF 696 Supporting Statement 18JUL16 REV JAN 17.doc Supporting Statement A	2017-01-27

IC Document Collections

IC ID	Document Title	Status
9945	Child Care and Development Fund Quarterly Financial Report Form and Instruction	Modified

ICR Details

OMB Control No: 0970-0163	ICR Reference No: 201610-0970-002
Status: Historical Active	Previous ICR Reference No: 201302-0970-003
Agency/Subagency: HHS/ACF	Agency Tracking No: OA
Title: Child Care and Development Fund Quarterly Financial Report (ACF-696)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/01/2017
	Date Received in OIRA: 10/06/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2020	36 Months From Approved
Responses	224	0	0
Time Burden (Hours)	1,120	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: States use this form to facilitate the reporting of expenditures for the Child Care and Development Fund. State agencies will use this form to report claim on a quarterly basis. The form provides specific data regarding financial disbursements, obligations, and estimates. It provides States with a mechanism to request grant awards and certify the availability of State matching funds. Failure to collect this data would seriously compromise the Administration for Children and Families ability to monitor expenditures. This form may also be used to prepare ACF burden submissions to Congress.

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Authorizing Statute(s): PL: Pub.L. 105 - 33 2 Name of Law: Balanced Budget Act of 1997
   PL: Pub.L. 111 - 5 604 Name of Law: Recovery Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 21553	04/12/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 64161	09/19/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Child Care and Development Fund Quarterly Financial Report	ACF-696	CCDF Financial Report

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	224	0	0	224	0	0
Annual Time Burden (Hours)	1,120	0	0	1,120	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a reinstatement.

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Annual Cost to Federal Government: $28,800

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/06/2016

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