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Program Instruction CCDF-ACF-PI-2007-02—FY 2008 Application and Plan Procedures for 102-477 Grantees: Child Count Declaration

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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