Program Instruction CCDF-ACF-PI-2009-06—FY 2010 Application and Plan Procedures for 102-477 Grantees

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Attachment B: Child Count Declaration

 

Name of Tribal Lead Agency: ____________________________________

This certifies that the number of Indian children under age 13 (as defined in the CCDF section of the 102-477 plan) who reside on or near the reservation or service area (as defined in the CCDF section of the 102-477 plan) is:   number  .

 

This count shows the number of Indian children under age 13 as of   Date   .

 

REQUEST FOR FY 2009 REALLOTTED TRIBAL DISCRETIONARY FUNDS

The Tribal Lead Agency named above requests FY 2009 Discretionary Funds that may be available through the reallotment process.

                                                                         _______YES _______ NO

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