Home > Laws & Policies > Policy/Program Issuances > Program Instructions > PI-08-03 > Attachement B: CFS-101, PART III: Annual Expenditures for Title IV-B, Subparts 1 and 2, Chafee Foster Care Independence (CFCIP) and Education And Training Voucher (ETV) : Fiscal Year 2006: October 1, 2005 through September 30, 2006

U.S. Department of Health and Human Services Administration for Children and Families

Attachment B

CFS-101, PART III: Annual Expenditures for Title IV-B, Subparts 1 and 2, Chafee Foster Care Independence (CFCIP) and Education And Training Voucher (ETV) : Fiscal Year 2006: October 1, 2005 through September 30, 2006

1. State or ITO:	2. EIN:	3. Address:
4. Submission: [ ] New [ ] Revision
Description of Funds	Estimated Expenditures	Actual Expenditures	Number Served		Population served	Geographic area served
			Individuals	Families
5. Total title IV-B, subpart 1 funds	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
a) Total Administrative Costs (not to exceed 10% of Federal allotment)	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
6. Total title IV-B, subpart 2 funds (This amount should equal the sum of lines a - g).	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
a) Family Preservation Services	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
b) Family Support Services	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
c) Time-Limited Family Reunification Services	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
d) Adoption Promotion and Support Services	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
e) Total for Other Service Related Activities (e.g. planning)	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
f) Monthly Caseworker Visits (FOR STATES)	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
g) Total Administrative Costs (FOR STATES: not to exceed 10% of total allotment after October 1, 2007)	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
7. Total Chafee Foster Care Independence Program (CFCIP) funds	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
a) Indicate the amount of State's allotment spent on room and board for eligible youth (not to exceed 30% of CFCIP allotment)	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
8. Total Education and Training Voucher (ETV) funds	$	$	Blank Cell	Blank Cell	Blank Cell	Blank Cell
9. Certification by State Agency or Indian Tribal Organization (ITO). The State agency or ITO agrees that expenditures were made in accordance with the Child and Family Services Plan, which has been jointly developed with, and approved by, the Children's Bureau, for the Fiscal Year ending September 30, 20__.
Signature and Title of State/Tribal Agency Official	Date	Signature and Title of Central Office Official				Date

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Attachments

PI 08-03
HTML or PDF (141 KB)

Attachment A: FFY 2008 Allocation Tables:

• Title IV-B, subpart 1, Child Welfare Services (CWS)
  HTML or PDF (19 KB)
• Title IV-B, subpart 2, Promoting Safe and Stable Families (PSSF)
  HTML or PDF (42 KB)
• Child Abuse and Neglect Prevention and Treatment Act (CAPTA)
  HTML or PDF (18 KB)
• Chafee Foster Care Independence Program (CFCIP)
  HTML or PDF (38 KB)
• Education and Training Vouchers (ETV)
  HTML or PDF (17 KB)

(FFY 2009 Estimated Allotments for Monthly Caseworker Visits funds are pending and will be released shortly.)

Attachment B: CFS-101

• Part I: Annual Budget Request for Title IV-B, Subpart 1 & 2 Funds, CAPTA, CFCIP, and ETV Instructions
  HTML or PDF (34 KB)
• Part I: Annual Budget Request for Title IV-B, Subpart 1 & 2 Funds, CAPTA, CFCIP, and ETV Form
  HTML or PDF (10 KB) or Word (41 KB)
• Part II: Annual Summary of Child and Family Services Instructions
  HTML or PDF (41 KB)
• Part II: Annual Summary of Child and Family Services Form
  HTML or PDF (31 KB) or Word (84 KB)
• Part III: Annual Expenditures for Title IV-B, Subparts 1 and 2, Chafee Foster Care Independence (CFCIP) and Education And Training Voucher (ETV) Instructions
  HTML or PDF (29 KB)
• Part III: Annual Expenditures for Title IV-B, Subparts 1 and 2, Chafee Foster Care Independence (CFCIP) and Education And Training Voucher (ETV) Form
  HTML or PDF (24 KB) or Word (54 KB)

Attachment C: Children's Bureau Sampling Strategy for Caseworker Visits Data
HTML or PDF (13 KB)

Attachment D: Assurances and Certificates
HTML or PDF (61 KB)

Attachment E: Children's Bureau Regional Program Managers
HTML or PDF (16 KB)

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