TANF Data Reporting System - TANF - Section 1

TANF DATA REPORT - SECTION 1
TANF DISAGGREGATED DATA COLLECTION FOR FAMILIES RECEIVING ASSISTANCE UNDER
THE TANF PROGRAM


GENERAL INFORMATION

1.	State FIPS Code				2.	County FIPS Code				3.	Tribal Code (For Tribal Use Only)						4.	Reporting Month									5.	Stratum
																		Year					Month

																		Y	Y	Y	Y		M	M

FAMILY LEVEL DATA

6.	Case Number - TANF																7.	ZIP Code


	8.	Funding Stream				9.	Disposition				10.	New Applicant					11.	Number of Family Members					12.	Type of Family for Work Participation



ASSISTANCE RECEIVED BY THE FAMILY

13.	Receives Subsidized Housing				14.	Receives Medical Assistance				15.	Receives Food Stamps				16.	Amount of Food Stamps Assistance					17.	Receives Subsidized Child Care					18.	Amount of Subsidized Child Care


19.	Amount of Child Support						20.	Amount of the Family's Cash Resources


ASSISTANCE PROVIDED UNDER STATE (TRIBAL) TANF PROGRAM, BY TYPE

21.	Cash and Cash Equivalent
A.	Amount							B.	Number of Months


22.	TANF Child Care																				23.	. Transportation
A.	Amount					B.	Number of Children Covered				C.	Number of Months										A.	Amount							B.	Number of Months


24.	Transitional Services																				25.	Other Assistance
	A.	Amount						B.	Number of Months													A.	Amount							B.	Number of Months


REASON FOR AND AMOUNT OF REDUCTION IN ASSISTANCE

26.	Reason and Amount of Reduction in Assistance
	A.	Sanctions:
	i.	Total Dollar Amount for Reduction Due to Sanctions				ii.	Work Requirements Sanction				iii.	Family Sanction for an Adult with No High School Diploma or Equivalent					iv.	Sanction for Teen Parent Not Attending School				v.	Non-cooperation with Child Support			vi.	Failure to Comply with an Individual Responsibility Plan				vii.	Other Sanction


	B.	Recoupment of Prior Overpayment						C.	Other:
									i.	Total Dollar Amount of Reduction Due to Other Reasons							ii.	Family Cap				iii.	Reduction Based on Length of Receipt of Assistance					iv.	Other, Non-sanction


27.	Waiver Evaluation Research Group							28.	Is the TANF Family Exempt from Federal Time Limit Provisions														29.	Is the TANF Family a New Child-Only Family?


PERSON LEVEL DATA

ADULT AND MINOR CHILD HEAD-OF-HOUSEHOLD CHARACTERISTICS

Adult			30.	Family Affiliation			31.	Non-Custodial Parent Indicator			32.	Date of Birth (Age)								33.	Social Security Number
											Y	Y	Y	Y	M	M	D	D
	1																						-			-
	2																						-			-
	3																						-			-
	4																						-			-
	5																						-			-
	6																						-			-

			34.	Race/Ethnicity
			Ethnicity						Race
Adult			A.	Hispanic or Latino					B.	American Indian of Alaska Native				C.	Asian			D.	Black or African American				E.	Native Hawaiian or Pacific Islander				F.	White
	1
	2
	3
	4
	5
	6

							36.	Receives Disability Benefits
Adult			35.	Gender			A.	Receives Federal Disability Insurance Benefits - OASDI					B.	Receives Benefits Based on Federal Disability Status					C.	Receives Aid Under Title XIV-APDT				D.	Receives Aid Under Title XVI-AABD				E.	Receives Aid Under Title XVI-SSI
	1
	2
	3
	4
	5
	6

Adult			37.	Marital Status			38.	Relationship to Head of Household				39.	Parent with Minor Child in the Family			40.	Needs of a Pregnant Woman			41.	Educational Level				42.	Citizenship / Alienage
	1
	2
	3
	4
	5
	6

Adult			43.	Cooperation in Child Support			44.	Number of Months Countable Toward Federal Time Limit				45	Number of Countable Months Remaining Under State's (Tribe's) Time Limit					46.	Is Current Month Exempt From State's (Tribe's) Time Limit				47.	Employment Status			48.	Work-Eligible Individual Indicator			49.	Work Parti cipation
	1
	2
	3
	4
	5
	6

ADULT WORK PARTICIPATION ACTIVITIES

Adult			50.	Unsubsidized Employment					51.	Subsidized Private Sector Employment					52.	Subsidized Public Sector Employment					53.	Work Experience					54.	On-the-Job Training
	1
	2
	3
	4
	5
	6
																											59.	Education Directly Related to Employment for Individuals with No High School Diploma or Certificate of High School Equivalency
Adult			55.	Job Search and Job Readiness Assistance					56.	Community Service Programs					57.	Vocational Educational Training					58.	Job Skills Training Directly Related to Employment					59.
	1
	2
	3
	4
	5
	6

Adult			60.	Satisfactory School Attendance for Individuals with No High School Diploma or Certificate of High School Equivalency						61.	Providing Child Care Services to an Individual Who is Participating in a Community Service Program						62.	Additional Work Activities Permitted Under Waiver Demonstration					63.	Other Work Activities				64.	Required Hours of Work Under Waiver Demonstration
	1
	2
	3
	4
	5
	6

AMOUNT OF INCOME, BY TYPE

							66.	Amount of Unearned Income
Adult		65.	Amount of Earned Income				A.	Earned Income Tax Credit - EITC				B.	Social Security				C.	SSI				D.	Worker's Compensation				E.	Other Unearned Income
1
2
3
4
5
6

CHILD CHARACTERISTICS

Child			67.	Family Affiliation					68.	Date of Birth (Age)										69.	Social Security Number
									Y	Y	Y	Y	M	M	D	D
	1																						-			-
	2																						-			-
	3																						-			-
	4																						-			-
	5																						-			-

Child			67.	Family Affiliation					68.	Date of Birth (Age)										69.	Social Security Number
									Y	Y	Y	Y	M	M	D	D
	6																						-			-
	7																						-			-
	8																						-			-
	9																						-			-
	10																						-			-

			70.	Race/Ethnicity
			Ethnicity						Race
Child			A.	Hispanic or Latino					B.	American Indian or Alaska Native				C.	Asian			D.	Black or African American				E.	Native Hawaiian or Pacific Islander				F.	White
	1
	2
	3
	4
	5
	6
	7
	8
	9
	10

							72.	Receives Disability Benefits:
Child			71.	Gender			A.	Receives Benefits Based on Federal Disability Status					B.	Receives Aid Under Title XVI-SSI					73.	Relationship to Head of Household				74.	Parent with Minor Child in the Family				75.	Educational Level
	1
	2
	3
	4
	5
							72.	Receives Disability Benefits:
Child			71.	Gender			A.	Receives Benefits Based on Federal Disability Status					B.	Receives Aid Under Title XVI-SSI					73.	Relationship to Head of Household				74.	Parent with Minor Child in the Family				75.	Educational Level
	6
	7
	8
	9
	10

Child			76.	Citizenship / Alienage							77.	Amount of Unearned Income
Child			76.	Citizenship / Alienage							A.	SSI					B.	Other Unearned Income
	1
	2
	3
	4
	5
	6
	7
	8
	9
	10