CCDF Financial Reporting Form (ACF-696T) |
| Comment: On December 5, 2000, the Child Care Bureau released Program Instruction ACYF-PI-00-07, Form ACF-696T and Guide for Tribal Child Care financial reporting |
| Index: List of ACF Regional Administrators | ACYF-PI-CC-99-06 | ACF-696T Form | ACF-696T Instructions | (Collection also available in Word and PDF) |
| Related Items: None |
Form ACF-696T (To print use Excel or PDF versions) |
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U. S. DEPARTMENT OF HEALTH AND HUMAN
SERVICES
ADMINISTRATION FOR CHILDREN AND FAMILIES |
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CHILD CARE AND DEVELOPMENT FUND ACF-696T FINANCIAL
REPORT
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TRIBE:
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FISCAL YEAR: | SUBMISSION (MARK ONE
BOX) ORIGINAL [ ] REVISED [ ] |
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|---|---|---|---|---|---|
| DOC. #(s): | |||||
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CUMULATIVE FISCAL YEAR TOTALS
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COLUMN(A)
TRIBAL MANDATORY FUNDS |
COLUMN
(B)
TRIBAL DISC.FUNDS (NOT INCLUDING BASE) |
COLUMN(C)
DISCRETIONARY FUNDSBASE AMOUNT |
COLUMN
(D)
CONST. & RENOVATION TRIBAL MANDATORY |
COLUMN
(E)
CONST. & RENOVATION DISCRETIONARY |
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| 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 | $ | $ | $ | $ | $ |
| 6(A). SYSTEMS | $ | $ | $ | $ | $ |
| 6(B). CERTIFICATE PROGRAM COSTS | $ | $ | $ | $ | $ |
| 6(C). ELIGIBILITY DETERMINATION/OTHER NON-DIRECT | $ | $ | $ | $ | $ |
| 7. EXPENDITURES FOR QUALITY ACTIVITIES | $ | $ | $ | $ | $ |
| 8. EXPENDITURES FOR CONSTRUCTION / RENOVATION | $ | $ | |||
| 9. TOTAL FEDERAL EXPENDITURES | $ | $ | $ | $ | $ |
| 10. TOTAL FEDERAL UNLIQUIDATED OBLIGATIONS | $ | $ | $ | $ | $ |
| 11. TOTAL FEDERAL UNOBLIGATED BALANCE | $ | $ | $ | $ | $ |
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REALLOTTED FUNDS PLEASE
REFER TO REALLOTTED FUNDS INFORMATION ON PAGE FIVE (5) OF THE
INSTRUCTIONS. 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.
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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.
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| SIGNATURE: TRIBAL OFFICIAL | TYPED NAME, TITLE, LEAD AGENCY NAME, PHONE #, FAX # | ||||
| DATE SUBMITTED: | CONTROL NO. 0970-0195 | ||||
| FORM ACF-696T PAGE 1 OF 1 | EXPIRATION DATE: 02/28/2002 | ||||
| Index: List of ACF Regional Administrators | ACYF-PI-CC-99-06 | ACF-696T Form | ACF-696T Instructions | (Collection also available in Word and PDF) |
| Related Items: None |