ATTACHMENT B
| CERTIFICATION OF
TRIBAL POPULATION UNDER AGE 21
The _______________________________________________________ (Tribal Name and State) has read the ACF Program Instruction listing the Census Bureau year 2000 under age 21 population for Tribes and finds that the data do not accurately reflect the actual number of children in our Tribe. The correct number of Tribal members under age 21 is ___________________ . The reason that our population number is different from the
Census Bureau is: (attach additional page(s) if necessary) We understand that information given above will be reviewed by ACF and that we may be required to submit additional supporting documentation as requested by ACF to substantiate this notification of change in population data. We are submitting this information and certify that it is accurate and true to the best of our knowledge and belief. This certification requires the signatures of both the Tribal enrollment coordinator and Tribal leader responsible for ACF programs.
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