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ACF-696T Form - 2017

Published: April 19, 2017
Categories:
Child Care Development Fund (CCDF) Reporting
Topics:
ACF-696T, Tribes
Types:
Form
 

U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
ADMINISTRATION FOR CHILDREN AND FAMILIES

CHILD CARE AND DEVELOPMENT FUND ACF-696T FINANCIAL REPORT
TRIBE: FISCAL YEAR GRANT WAS AWARDED:  GRANT DOC. #(s): SUBMISSION (MARK ONE BOX)
EXPENDITURE PERIOD: 10/1 ____TO 9/30_______  FINAL REPORT   YES [   ]   NO [   ] ORIGINAL [  ]  REVISED [  ]
CUMULATIVE FISCAL YEAR TOTALS
  COLUMN (A)
TRIBAL MANDATORY FUNDS
COLUMN (B)
DISCRETIONARY FUNDS
(NOT INCLUDING BASE)
COLUMN (C)
DISCRETIONARY
FUNDS (Base Amount)
 
COLUMN (D)
CONST. & RENOVATION
TRIBAL MANDATORY
COLUMN (E)
CONST. & RENOVATION
DISCRETIONARY
1. FEDERAL FUNDS AWARDED $ $ $    
2. TRANSFER TO CONSTRUCTION / RENOVATION $ $ $    
3. TOTAL FUNDS AVAILABLE $ $ $ $ $
      
4. EXPENDITURES FOR CHILD CARE SERVICES $ $ $ $ $
5. EXPENDITURES FOR CHILD CARE ADMINISTRATION $ $ $ $ $
6. EXPENDITURES FOR NON-DIRECT SERVICES (INCLUDING SYSTEMS, CERTIFICATE PROGRAM, AND ELIGIBILITY DETERMINATION COSTS) $ $ $ $ $
7. EXPENDITURES FOR QUALITY ACTIVITIES $ $ $ $ $
8. EXPENDITURES FOR CONSTRUCTION/ RENOVATION       $ $
9. TOTAL FEDERAL EXPENDITURES $ $ $ $ $
10. TOTAL FEDERAL UNLIQUIDATED OBLIGATIONS $ $ $ $ $
11. TOTAL FEDERAL UNOBLIGATED BALANCE $ $ $ $ $

REALOTTED FUNDS

PLEASE REFER TO REALLOTTED FUNDS INFORMATION IN THE INSTRUCTIONS.

IF AVAILABLE, DOES THE TRIBE REQUEST REALLOTTED DISCRETIONARY FUNDS? YES [ ]  NO [ ].

IF THIS REPORT IS NOT RECEIVED WITHIN 90 DAYS AFTER THE END OF THE FISCAL YEAR (12/29), THE TRIBE WILL NOT BE ELIGIBLE FOR REALLOTMENT.

THIS IS TO CERTIFY THAT THE INFORMATION REPORTED ON ALL PARTS OF THIS FORM IS ACCURATE AND TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF.

THIS ALSO CERTIFIES THAT THE TRIBAL LEAD AGENCY HAS EXPENDED REQUIRED FUNDS THAT ARE TARGETED FOR CHILD CARE RESOURCE AND REFERRAL AND SCHOOL-AGE CARE ACTIVITIES..

SIGNATURE: TRIBAL OFFICIAL TYPED NAME, TITLE, LEAD AGENCY NAME, PHONE #, FAX #

 

 

 

 

 

 

DATE SUBMITTED: OMB CONTROL NO. 0970-0195   HAS ANY CONTACT INFORMATION CHANGED SINCE LAST YEAR?
[ ] YES [ ] NO
FORM ACF-696T PAGE 1 OF 1 EXPIRATION DATE: 02/29/2020  

 

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Last Reviewed: April 19, 2017