Program Instruction CCDF-ACF-PI-2008-02; FY 2009 Tribal Application Plan Procedures for CCDF Grantees

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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).

 

                                                                                                                                           

         Signature of Individual Authorized to Act for the Tribe

 

REQUEST FOR FY 2008 REALLOTTED TRIBAL DISCRETIONARY FUNDS

The Tribal Lead Agency named above requests FY 2008 Discretionary Funds that may be available through the reallotment process.

                                                                         _______YES _______ NO

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