Appendices for TANF Program

Note: The following appendices will not appear in the Code of Federal Regulations.

APPENDIX A

TANF Data Report - Section One

Disaggregated Data Collection

for Families Receiving Assistance under the TANF Program

Instructions and Definitions

General Instruction: The State agency or Tribal grantee should collect and report data for each data element, unless explicitly instructed to leave the field blank.

1. State FIPS Code: Enter your two-digit State code from the following listing. These codes are the standard codes used by the National Institute of Standards and Technology. Tribal grantees should leave this field blank.

State Code State Code

Alabama 01 Montana 30

Alaska 02 Nebraska 31

American Samoa 60 Nevada 32

Arizona 04 New Hampshire 33

Arkansas 05 New Jersey 34

California 06 New Mexico 35

Colorado 08 New York 36

Connecticut 09 North Carolina 37

Delaware 10 North Dakota 38

Dist. Of Columbia 11 Ohio 39

Florida 12 Oklahoma 40

Georgia 13 Oregon 41

Guam 66 Pennsylvania 42

Hawaii 15 Puerto Rico 72

Idaho 16 Rhode Island 44

Illinois 17 South Carolina 45

Indiana 18 South Dakota 46

Iowa 19 Tennessee 47

Kansas 20 Texas 48

Kentucky 21 Utah 49

Louisiana 22 Vermont 50

Maine 23 Virgin Islands 78

Maryland 24 Virginia 51

Massachusetts 25 Washington 53

Michigan 26 West Virginia 54

Minnesota 27 Wisconsin 55

Mississippi 28 Wyoming 56

Missouri 29

2. County FIPS Code: Enter the three-digit code established by the National Institute of Standards and Technology for classification of counties and county equivalents. Codes were devised by listing counties alphabetically and assigning sequentially odd codes is available in Appendix F of the TANF Sampling and Statistical Methods Manual. Tribal grantees should leave this field blank.

3. Tribal Code: For Tribal grantees, enter the three-digit Tribal code that represents your Tribe (See Appendix E of the TANF Sampling and Statistical Methods Manual for a complete listing of Tribal Codes). State agencies should leave this field blank.

4. Reporting Month: Enter the four-digit year and two-digit month code that identifies the year and month for which the data are being reported.

5. Stratum:

Guidance: All TANF families selected in the sample from the same stratum must be assigned the same stratum code. Valid stratum codes may range from "00" to "99." States and Tribes with stratified samples should provide the ACF Regional Office with a listing of the numeric codes utilized to identify any stratification. If a State or Tribe opts to provide data for its entire caseload, enter the same stratum code (any two-digit number) for each TANF family.

Instruction: Enter the two-digit stratum code.

Family-Level Data

Definition: For reporting purposes, the TANF family means (a) all individuals receiving assistance as part of a family under the State's TANF Program; and (b) the following additional persons living in the household, if not included under (a) above:

(1) Parent(s) or caretaker relative(s) of any minor child receiving assistance;

(2) Minor siblings (including unborn children) of any child receiving assistance; and

(3) Any person whose income or resources would be counted in determining the family's eligibility for or amount of assistance.

6. Case Number - TANF:

Guidance: If the case number is less than the allowable eleven characters, a State may use lead zeros to fill in the number.

Instruction: Enter the number assigned by the State agency or Tribal grantee to uniquely identify the case after formal approval to receive assistance.

7. ZIP Code: Enter the five-digit ZIP code for the TANF family's place of residence for the reporting month.

8. Funding Stream: For States that bifurcate their caseloads, enter the appropriate code for the funding stream used to provide assistance to this TANF family. If the State (Tribe) does not bifurcate its caseload, enter code "1."

1 = Funded, in whole or in part, with Federal TANF block grant funds

2 = Funded entirely from State-only funds (segregated State TANF program) which are subject to TANF rules.

9. Disposition:

Guidance: A family that did not receive any assistance for the reporting month but was listed on the monthly sample frame for the reporting month is "listed in error." States are to complete data collection for all sampled cases that are not listed in error.

Instruction: Enter one of the following codes for each TANF sampled case.

1 = Data collection completed

2 = Not subject to data collection/listed in error

10. New Applicant:

Guidance: A newly-approved applicant means the current reporting month is the first month for which the TANF family has received TANF assistance (and thus has had a chance to be selected into the TANF sample). This may be either the first month that the TANF family has ever received assistance or the first month of a new spell on assistance. A TANF family that is reinstated from a suspension is not a newly, approved applicant.

Instruction: Enter the one-digit code that indicates whether or not the TANF family is a newly-approved applicant.

1 = Yes, a newly-approved application

2 = No

11. Number of Family Members: Enter two digits that represent the number of members in the family receiving assistance under the State's (Tribe's) TANF Program during the reporting month.

12. Type of Family for Work Participation:

Guidance: This data element will be used to identify the type of family (i.e., the number of parents or care-taker relatives in the family receiving assistance) in order to calculate the all family and the two-parent family work participation rates. A family with a minor child head-of-household should be coded as either a single-parent family or two-parent family, whichever is appropriate. A family that includes a disabled parent will not be considered a two-parent family for purposes of the work participation rate. A noncustodial parent, who lives in the State, may participate in work activities funded under the State TANF Program and receive other assistance. In order for the noncustodial parent to participate in work activities and receive assistance, (s)he must be a member of the eligible family receiving assistance and be reported as part of the TANF family. However, it is up to the State to consider whether a family with a non-custodial parent is a one-parent or two-parent family for the purposes of calculating the work participation rate.

Instruction: Enter the one-digit code that represents the type of family for purposes of calculating the work participation rates.

1 = Single-Parent Family for participation rate purposes

2 = Two-Parent Family for participation rate purposes

3 = No Parent Family for participation rate purposes (does not include parents, care-taker relatives, or minor child heads-of-household

13. Receives Subsidized Housing:

Guidance: Subsidized housing refers to housing for which money was paid by the Federal, State, or Local government or through a private social service agency to the family or to the owner of the housing to assist the family in paying rent. Two families sharing living expenses does not constitute subsidized housing.

Instruction: Enter the one-digit code that indicates whether or not the TANF family received subsidized housing for the reporting month.

1 = Public housing

2 = HUD rent subsidy

3 = Other rent subsidy

4 = No housing subsidy

14. Receives Medical Assistance: Enter "1" if, for the reporting month, any TANF family member is eligible to receive (i.e., a certified recipient of) medical assistance under the State plan approved under Title XIX or "2" if no TANF family member is eligible to receive medical assistance under the State plan approved under Title XIX.

1 = Yes, receives medical assistance

2 = No

15. Receives Food Stamps:

If the TANF family received Food Stamps for the reporting month, enter the one-digit code indicating the type of Food Stamp assistance. Otherwise, enter "4."

1 = Yes, Food Stamp coupon allotment

2 = Yes, cash

3 = Yes, wage subsidy

4 = No

16. Amount of Food Stamp Assistance:

Guidance: For situations in which the Food Stamp household differs from the TANF family, code this element in a manner that most accurately reflects the resources available to the TANF family.

Instruction: Enter the TANF family's authorized dollar amount of Food Stamp assistance for the reporting month.

17. Receives Subsidized Child Care:

Guidance: For the purpose of coding this data element, Subsidized Child Care funded under the Child Care and Development Fund with funds that were transferred from the State TANF Program should be coded as "2."

Instruction: If the TANF family receives subsidized child care for the reporting month, enter code "1", "2", "3", or "4", whichever is appropriate. Otherwise, enter code "5."

1 = Yes, funded under the State (Tribal) TANF Program

2 = Yes, funded under the Child Care and Development Fund

3 = Yes, funded under another Federal program (e.g., SSBG)

4 = Yes, funded under a State, Tribal, or local program

5 = No

18. Amount of Subsidized Child Care:

Guidance: Subsidized child care means a grant by the Federal, State or Local government to a parent (or care-taker relative) to support, in part or whole, the cost of child care services provided by an eligible provider to an eligible child. The grant may be paid directly to the parent (or care-taker relative) or to a child care provider on behalf of the parent (or care-taker relative).

Instruction: Enter the dollar amount of subsidized child care that the TANF family has received for services in the reporting month. If the TANF family did not receive any subsidized child care for the reporting month, enter "00."

19. Amount of Child Care Disregard: Enter the total dollar amount of the TANF family's actual disregard allowed for child care expenses during the reporting month. If there is no child care disregard, enter "0" as the amount.

20. Amount of Child Support: Enter the total dollar value of child support received on behalf of the TANF family in the reporting month, which includes arrearages, recoupments, and pass-through amounts whether paid to the State or the family.

21. Amount of the Family's Cash Resources: Enter the total dollar amount of the TANF family's cash resources for the reporting month.

Amount of Assistance Received and the Number of Months that the Family Has Received Each Type of Assistance under the State (Tribal) TANF Program:

Guidance: Assistance means every form of support provided to TANF families under the State (Tribal) TANF Program (including child care, work subsidies, and allowances to meet living expenses), except for the following:

1) services that have no direct monetary value to an individual family and that do not involve implicit or explicit income support, such as counseling, case management, peer support and employment services that do not involve subsidies or other forms of income support; and

2) one-time, short-term assistance (i.e., assistance paid within a 30-day period, no more than once in any twelve-month period, to meet needs that do not extend beyond a 90-day period, such as automobile repair to retain employment and avoid welfare receipt and appliance repair to maintain living arrangements).

Instruction: For each type of assistance provided under the State's (Tribal) TANF Program, enter the dollar amount of assistance that the TANF family received or that was paid on behalf of the TANF family for the reporting month and the number of months that the TANF family has received assistance under the State's (Tribe's) TANF program. If, for a "type of assistance", no dollar amount of assistance was provided during the reporting month, enter "0" as the amount. If, for a "type of assistance", no assistance has been received (since the State began its TANF Program) by the TANF eligible family, enter "0" as the number of months of assistance.

22. Cash and Cash Equivalents:

A. Amount B. Number of Months

23. Educational:

A. Amount B. Number of Months

24. Employment Services:

A. Amount B. Number of Months

25. Work Subsidies:

A. Amount B. Number of Months

26. TANF Child Care:

Guidance: Include only the child care funded directly by the State (Tribal) TANF Program. Do not include child care funded under the Child Care and Development Fund, even though some of the funds were transferred to the CCDF from the TANF program.

A. Amount B. Number of Months

27. Transportation:

A. Amount B. Number of Months

28. Other Supportive Services and Special Needs, including Assistance with Meeting Home Heating and Air Conditioning Costs:

A. Amount B. Number of Months

29. Transitional Services:

A. Amount B. Number of Months

30. Contributions to Individual Development Accounts:

A. Amount B. Number of Months

31. Other:

A. Amount B. Number of Months

Reason for and Amount of Reduction in Assistance

For each reason for which the TANF family received a reduction in assistance for the reporting month, enter the dollar amount of the reduction in assistance. Otherwise, enter "0."

32. Work Requirements Sanction

33. Family Sanction for an Adult with No High School Diploma or Equivalent

34. Sanction for Teen Parent not Attending School

35. Non-Cooperation with Child Support

36. Failure to Comply with an Individual Responsibility Plan

37. Other Sanction

38. Recoupment of Prior Overpayment

39. Family Cap

40. Reduction Based on Family Moving into State From Another State

41. Reduction Based on Length of Receipt of Assistance

42. Other, Non-sanction

43. Waiver Evaluation Research Group:

Guidance: In connection with waivers, approved to allow States to implement Welfare Reform Demonstrations, a State assigned a portion of its cases to a research group consisting of a control group (subject to the provisions of the regular, statutory AFDC program as defined by prior law) and an experimental group (subject to the provisions of the regular, statutory AFDC program as defined by prior law as modified by waivers). A state may choose, for the purpose of completing impact analyses, to continue a research group and thus maintain applicable control and experimental group treatment policies as they were implemented under their welfare reform demonstration (including prior law policies not modified by waivers), even if such policies are inconsistent with TANF. However, cases assigned to a non-experimental treatment group (i.e., not part of the research group) may not apply prior law policies inconsistent with TANF unless such policies are specifically linked to approved waivers. Where a state continues waivers, but does not continue a research group for impact evaluation purposes, all cases in the demonstration site will be treated as non-experimental treatment group cases regardless of their original assignment as control or experimental cases.

Instruction: Enter the one-digit code that indicates the family's waiver evaluation case status.

Blank = Not applicable (no waivers apply to this case)

1 = Control group (for impact analysis purposes)

2 = Experimental group

3 = Non-experimental treatment group

44. Is the TANF Family Exempt from the Federal Time Limit Provisions:

Guidance: Under TANF rules, an eligible family that does not include an adult (or minor child head-of-household) recipient, who has received assistance for 60 countable months, may continue to receive assistance. A countable month is a month of assistance for which the adult (or minor child head-of-household) is not exempt from the Federal time limit provisions. TANF rules provide for two categories of exceptions. First, a family which does not include an adult (or minor child head-of-household) who has received 60 countable months of assistance may be exempt from the accrual of months of assistance (i.e., clock not ticking). Second, a family with an adult (or minor child head-of-household), who has received 60 countable months of assistance may be exempt from termination of assistance. Exemptions from termination of assistance include a hardship exemption which allows up to 20% of the families to receive assistance beyond the 60 month time limit. In lieu of the 20% hardship exemptions, States may choose to employ extension policies prescribed under approved waivers.

Instruction: If the TANF family has no exemption from the Federal five-year time limit, enter code "1." If the TANF family does not include an adult (or minor child head-of-household) who has received assistance for 60 countable months and is exempt from accrual of months of assistance under the Federal five-year time limit for the reporting month, enter "2", "3", or "4", whichever is appropriate. If the TANF family includes an adult (or minor child head-of-household) who has received assistance for 60 countable months and the family is exempt from termination of assistance, enter code "5", "6", "7" or "8", whichever is appropriate.

01 = Family is not exempt from Federal time limit.

Family does not include an adult (or minor child head-of-household) who has received assistance for 60 countable months

02 = Yes, family is exempt from accrual of months under the Federal five-year time limit for the reporting month because no adult or minor child head-of-household in eligible family receiving assistance.

03 = Yes, family is exempt from accrual of months under the Federal five-year time limit for the reporting month because assistance to family is funded entirely from State-only funds.

04 = Yes, family is exempt from accrual of months under the Federal five-year time limit for the reporting month because the family is living on an Indian country of at least 1,000 persons at least 50 percent of whose adults are unemployed.

05 = Yes, family is exempt from accrual of months under the Federal five-year time limit for the reporting month based on an approved waiver policy.

Family includes an adult (or minor child head-of-household) who has received assistance for 60 countable month

06 = Yes, family is exempt from termination of assistance under the Federal five-year time limit for the reporting month because assistance to family is funded entirely from State-only funds.

07 = Yes, family is exempt from termination of assistance under the Federal five-year time limit for the reporting month due to a temporary good cause domestic violence waiver (and an inability to work).

08 = Yes, family is exempt from termination of assistance under the Federal five-year time limit for the reporting month due to a hardship exemption for reason other than domestic violence.

09= Yes, family is exempt from termination of assistance under the Federal five-year time limit for the reporting month because the adult's (minor child head-of-household's) residence is on an Indian country of at least 1,000 persons at least 50 percent of whose adults are unemployed.

10 = Yes, family (including adults) is exempt from termination of assistance under the Federal five-year time limit for the reporting month in accordance with extension policies prescribed under approved waivers.

11 = Yes, the children in the family are receiving assistance beyond the 60 countable months and the family is exempt from termination of assistance under the Federal five-year time limit for the reporting month in accordance with extension policies prescribed under approved waivers (i.e., adult-only time limit).

Person-Level Data

Person-level data has two sections: the adult and minor child head-of-household characteristic section and the child characteristics section. Section 419 of the Act defines adult and minor child. An adult is an individual that is not a minor child. A minor child is an individual who (a) has not attained 18 years of age or (b) has not attained 19 years of age and is a full-time student in a secondary school (or in the equivalent level of vocational or technical training.)

Adult and Minor Child Head-of-Household Characteristics

This section allows for coding up to six adults (or a minor child who is either a head-of-household or married to the head-of-household and up to five adults) in the TANF family. A minor child who is either a head-of-household or married to the head-of-household should be coded as an adult and will hereafter be referred to as a "minor child head-of-household." For each adult (or minor child head-of-household) in the TANF family, complete the adult characteristics section. If a noncustodial parent is participating in work activities funded under the State (Tribal) TANF Program for the reporting month, the noncustodial parent must also be reported in this section as a member of the family receiving assistance.

If there are more than six adults (or a minor child head-of-household and five adults) in the TANF family, use the following order to identify the persons to be coded: (1) the head-of-household; (2) parents in the eligible family receiving assistance; (3) other adults in the eligible family receiving assistance; (4) Parents not in the eligible family receiving assistance; (5) caretaker relatives not in the eligible family receiving assistance; and (6) other persons, whose income or resources count in determining eligibility for or amount of assistance of the eligible family receiving assistance, in descending order the person with the most income to the person with least income.

45. Family Affiliation:

Guidance: This data element is used both for (1) the adult or minor child head-of-household section and (2) the minor child section. The same coding schemes are used in both sections. Some of these codes may not be applicable for adults.

Instruction: Enter the one-digit code that shows the adult's (or minor child head-of-household's) relation to the eligible family receiving assistance.

1 = Member of the eligible family receiving assistance

Not in eligible family receiving assistance, but in the household

2 = Parent of minor child in the eligible family receiving assistance

3 = Caretaker relative of minor child in the eligible family receiving assistance

4 = Minor sibling of child in the eligible family receiving assistance

5 = Person whose income or resources are considered in determining eligibility for or amount of assistance for the eligible family receiving assistance

46. Noncustodial Parent Indicator:

Guidance: A noncustodial parent means a parent who does not live with his/her child(ren). A noncustodial parent, who lives in the State, may participate in work activities funded under the State TANF Program. In order for the noncustodial parent to participate in work activities, (s)he must be a member of the eligible family receiving assistance and be reported as part of the TANF family.

Instruction: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) noncustodial parent status.

1 = Yes, a noncustodial parent

2 = No

47. Date of Birth: Enter the eight-digit code for date of birth for the adult (or minor child head-of-household) under the State (Tribal) TANF Program in the format YYYYMMDD.

48. Social Security Number: Enter the nine-digit Social Security Number for the adult (or minor child head-of-household) in the format nnnnnnnnn.

49. Race: Enter the one-digit code for the race of the TANF adult (or minor child head-of-household).

1 = White, not of Hispanic origin

2 = Black, not of Hispanic origin

3 = Hispanic

4 = American Indian or Alaska Native

5 = Asian or Pacific Islander

6 = Other

9 = Unknown

50. Gender: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) gender.

1 = Male

2 = Female

Receives Disability Benefits

The Act specifies five types of disability benefits. For each type of disability benefits, enter the one-digit code that indicates whether or not the adult (or minor child head-of-household) received the benefit.

51. Receives Federal Disability Insurance Benefits: Enter the one-digit code that indicates the adult (or minor child head-of-household) received Federal disability insurance benefits for the reporting month.

1 = Yes, received Federal disability insurance

2 = No

52. Receives Benefits Based on Federal Disability Status: Enter the one-digit code that indicates the adult (or minor child head-of-household) received benefits based on Federal disability status for the reporting month.

1 = Yes, received benefits based on Federal disability status

2 = No

53. Receives Aid Under Title XIV-APDT: Enter the one-digit code that indicates the adult (or minor child head-of-household) received aid under a State plan approved under Title XIV for the reporting month.

1 = Yes, received aid under Title XIV-APDT

2 = No

54. Receives Aid Under Title XVI-AABD: Enter the one-digit code that indicates the adult (or minor child head-of-household) received aid under a State plan approved under Title XVI-AABD for the reporting month.

1 = Yes, received aid under Title XVI-AABD

2 = No

55. Receives Aid Under Title XVI-SSI: Enter the one-digit code that indicates the adult (or minor child head-of-household) received aid under a State plan approved under Title XVI-SSI for the reporting month.

1 = Yes, received aid under Title XVI-SSI

2 = No

56. Marital Status: Enter the one-digit code for the adult's (or minor child head-of-household's) marital status for the reporting month.

1 = Single, never married

2 = Married, living together

3 = Married, but separated

4 = Widowed

5 = Divorced

57. Relationship to Head-of-Household:

Instruction: Enter the two-digit code that shows the adult's relationship (including by marriage) to the head of the household, as defined by the Food Stamp Program or as determined by the State (Tribe), (i.e., the relationship to the principal person of each person living in the household). If minor child head-of-household, enter code "01."

01 = Head of household

02 = Spouse

03 = Parent

04 = Daughter or son

05 = Stepdaughter or stepson

06 = Grandchild or great grandchild

07 = Other related person (brother, niece, cousin)

08 = Foster child

09 = Unrelated child

10 = Unrelated adult

58. Teen Parent With Child In the Family:

Guidance: A teen parent is a person who is under 20 years of age and that person's child is also a member of the TANF family.

Instruction: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) teen parent status.

1 = Yes, a teen parent

2 = No

Educational Level

Educational level is divided into two parts: the highest level of education attained and the highest degree attained.

59. Highest Level of Education Attained: Enter the two-digit code to indicate the highest level of education attained by the adult (or minor child head-of-household).

00 = No formal education

01-12 = Grade level completed in primary/secondary school including secondary level vocational school or adult high school

60. Highest Degree Attained: If the adult (or minor child head-of-household) has a degree(s), enter the one-digit code that indicates the adult's (or minor child head-of-household's) highest degree attained. Otherwise, leave the field blank.

0 = No degree

1 = High school diploma, GED, or National External Diploma Program

2 = Awarded Associate's Degree

3 = Awarded Bachelor's Degree

4 = Awarded graduate degree (Master's or higher)

5 = Other credentials (degree, certificate, diploma, etc.)

61. Citizenship/Alienage:

Guidance: As described in TANF-ACF-PA-97-1, States have the flexibility to: (1) use State MOE funds to serve "qualified" aliens, including those who enter on or after August 22, 1996; (2) use Federal TANF funds to serve "qualified" aliens who arrived prior to the enactment of the PRWORA on August 22, 1996 [such aliens who arrived after enactment are barred from receiving Federal TANF funds for five years from the date of entry, except for certain aliens such as refugees and asylees]; (3) use State MOE funds to serve legal aliens who are not "qualified"; and (4) use, under section 411(d) of PRWORA, State MOE funds to serve aliens who are not lawfully present in the U.S., but only through enactment of a State law, after the date of PRWORA enactment, which "affirmatively provides" for such benefits.

The citizenship/alienage is divided into four groups: individuals eligible (for the TANF Program based on citizenship/alienage), individuals eligible at State option, individuals not eligible, and status unknown.

Instruction: Enter the two-digit code that indicates the adult's (or minor child head-of-household's) citizenship/alienage.

Individuals Eligible for the TANF Program

01 = U.S. citizen, including naturalized citizens

02 = Permanent resident who has worked forty qualifying quarters; alien who is a veteran with an honorable discharge from the U.S. Armed Forces or is on active duty in the U.S. Armed Forces, or spouse or unmarried dependent children of such alien

03 = Qualified alien accorded refugee, Cuban or Haitian entrant, or Amerasian immigrant status (INS Form I-94) who has resided in the U.S. five years or less

04 = Qualified alien granted political asylum five or less years ago; qualified alien granted a withholding of deportation by INS (under sec. 243(h) or sec. 241(b)(3) of the INA) five or less years ago.

Individuals Eligible for the TANF Program at State Option

05 = Qualified alien, (including immigrant accorded permanent resident status ("green card"), parolee granted parole for at least one year under sec. 212(d)(5) of the INA, and certain battered aliens and their children who are determined to be qualified),who arrived in the U.S. prior to enactment (August 22, 1996) or who arrived in the U.S. on or after enactment and has resided in the U.S. more than five years

06 = Qualified alien accorded refugee, Cuban or Haitian entrant, or Amerasian immigrant status (INS Form I-94) who has resided in the U.S. more than five years

07 = Qualified alien granted political asylum or granted withholding of deportation by INS (under sec. 243(h) or sec. 241(b)(3) of the INA) more than five years ago;

Individuals Not Eligible for the TANF Program

08 = Qualified alien (other than a refugee, Cuban or Haitian entrant, Amerasian immigrant, asylee, or alien whose deportation has been withheld under sec. 243(h) or sec. 241(b)(3) of the INA) who arrived in the U.S. on or after enactment and has resided in the U.S. less than 5 years.

09 = Any alien who is not a qualified alien.

Status Unknown

99 = Unknown

62. Number of Months Countable toward Federal Time Limit in Own State (Tribe): Enter the number of months countable toward the adult's (or minor child head-of-household's) Federal five-year time limit based on assistance received from the State (Tribe).

63. Number of Months Countable toward Federal Time Limit in Other States or Tribes: Enter the number of months countable toward the adult's (or minor child head-of-household's) Federal five-year time limit based on assistance received from other States or Tribes.

64. Number of Countable Months Remaining Under State's (Tribe's) Time Limit: Enter the number of months that remain countable toward the adult's (or minor child head-of-household's) State (Tribal) time limit.

65. Is Current Month Exempt from the State's (Tribe's) Time Limit: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) current exempt status from State's (Tribe's) time limit.

1 = Yes, adult (or minor child head-of-household) is exempt from the State's (Tribe's) time limit for the reporting month

2 = No

66. Employment Status: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) employment status.

1 = Employed

2 = Unemployed, looking for work

3 = Not in labor force (i.e, unemployed, not looking for work, includes discouraged workers)

67. Work Participation Status:

Guidance:

Disregarded from the participation rate means the TANF family is not included in the calculation of the work participation rate.

Exempt means that the individual will not be penalized for failure to engage in work (i.e., good cause exception); however, the TANF family is included in the calculation of the work participation rate.

Instruction: Enter the two-digit code that indicates the adult's (or minor child head-of-household's) work participation status.

01 = Disregarded from participation rate, single custodial parent with child under 12 months

02 = Disregarded from participation rate because all of the following apply: required to participate, but not participating, sanctioned for the reporting month, but not sanctioned for more than 3 months within the preceding 12-month period

03 = Disregarded, family is part of an ongoing research evaluation (as a member of a control group or experimental treatment group) approved under Section 1115 of the Social Security Act

04 = Disregarded from participation rate, is participating in a Tribal Work Program, and State has opted to exclude all Tribal Work Program participants from its work participation rate

05 = Exempt, single custodial parent with child under age 6 and unavailability of child care

06 = Exempt, disabled (not using an extended definition under a State waiver)

07 = Exempt, caring for a severely disabled child (not using an extended definition under a State waiver)

08 = A temporary good cause domestic violence waiver (not using an extended definition under a State waiver)

09 = Exempt, State waiver

10 = Exempt, other

11 = Required to participate, but not participating, sanctioned for the reporting month and sanctioned for more than 3 months within the preceding 12-month period

12 = Required to participate, but not participating, sanctioned for the reporting month but not sanctioned for more than 3 months within the preceding 12-month period

13 = Required to participate, but not participating and not sanctioned for the reporting month

14 = Deemed engaged in work, teen head-of-household who maintains satisfactory school attendance

15 = Deemed engaged in work, single parent with child under age 6 and parent engaged in work activities for at least 20 hours per week

16 = Required to participate, participating but not meeting minimum participation requirements

17 = Required to participate, and meeting minimum participation requirements

99 = Not applicable (e.g., person living in household and whose income or resources are counted in determining eligibility for or amount of assistance of the family receiving assistance, but not in eligible family receiving assistance)

Adult Work Participation Activities:

Guidance: To calculate the average number of hours per week of participation in a work activity, add the number of hours of participation across all weeks in the month and divide by the number of weeks in the month. Round to the nearest whole number.

Some weeks have days in more than one month. Include such a week in the calculation for the month that contains the most days of the week (e.g., the week of July 27 - August 2, 1997 would be included in the July calculation). Acceptable alternatives to this approach must account for all weeks in the fiscal year. One acceptable alternative is to include the week in the calculation for whichever month the Friday falls (i.e., the JOBS approach.) A second acceptable alternative is to count each month as having 4.33 weeks.

During the first or last month of any spell of assistance, a family may happen to receive assistance for only part of the month. If a family receives assistance for only part of a month, the State (Tribe) may count it as a month of participation if an adult (or minor child head-of-household) in the family (both adults, if they are both required to work) is engaged in work for the minimum average number of hours for the full week(s) that the family receives assistance in that month.

Special Rules: Each adult (or minor child head-of-household) has a life-time limit for vocational educational training. Vocational educational training may only count as a work activity for a total of 12 months. For any adult (or minor child head-of-household) that has exceeded this limit, enter "0" as the average number of hours per week of participation in vocational education training, even if (s)he is engaged in vocational education training. The additional participation in vocational education training may be coded under "Other."

The exception to the above 12 month rule may be a State that received a waiver which is inconsistent with the provision limiting vocational education training. In this case the State would adhere to the terms and conditions of the waiver.

Limitations: The four limitations concerning job search and job readiness are: (1) Job search and job readiness assistance only count for 6 weeks in any fiscal year; (2) An individual's participation in job search and job readiness assistance counts for no more than 4 consecutive weeks; (3) If the State's (Tribe's) total unemployment rate for a fiscal year is at least 50 percent greater than the United States' total unemployment rate for that fiscal year or the State is a needy State (within the meaning of Section 403 (b)(6), then an individual's participation in job search or job readiness assistance counts for up to 12 weeks in that fiscal year; and (4) A State may count 3 or 4 days of job search and job readiness assistance during a week as a full week of participation, but only once for any individual.

For each week in which an adult (or minor child head-of-household) exceeds any of these limitations, use "0" as the number of hours in calculating the average number of hours per week of job search and job readiness, even if (s)he may be engaged in job search or job readiness activities.

If a State is operating its TANF Program under a waiver which permits broader rules for participation in job search and job readiness training, the TANF rules apply for coding this element and any additional participation in job search and job readiness training permitted under the waiver rules should be coded under the item "Additional Work Activities Permitted Under Waiver Demonstration."

Instruction: For each work activity in which the adult (or minor child head-of-household) participated during the reporting month, enter the average number of hours per week of participation, except as noted above. For each work activity in which the adult (or minor child head-of-household) did not participate, enter zero as the average number of hours per week of participation.

68. Unsubsidized Employment

69. Subsidized Private Sector Employment

70. Subsidized Public Sector Employment

71. Work Experience

72. Onthejob Training

73. Job Search and Job Readiness Assistance

Instruction: Do not count hours of participation in job search and job readiness training beyond the TANF limit where allowed by waivers in this item. Instead count the hours of participation beyond the TANF limit in the item "Additional Work Activities Permitted Under Waiver Demonstration." Otherwise, count the additional hours of work participation under the work activity "Other Work Activities."

74. Community Service Programs

75. Vocational Educational Training

Instruction: Do not count hours of participation in vocational educational training beyond the TANF 12 month life-time limit where allowed by waivers in this item. Instead count the hours of participation beyond the TANF limit in the item "Additional Work Activities Permitted Under Waiver Demonstration." Otherwise, count the additional hours of work participation under the work activity "Other Work Activities."

76. Job Skills Training Directly Related to Employment

77. Education Directly Related to Employment for Individuals with no High School Diploma or Certificate of High School Equivalency

78. Satisfactory School Attendance for Individuals with No High School Diploma or Certificate of High School Equivalency

79. Providing Child Care Services to an Individual Who Is Participating in a Community Service Program

80. Additional Work Activities Permitted Under Waiver Demonstration

Instruction: Hours of participation in job search, job readiness training, or other work activities beyond the TANF limits as permitted by the State waiver should be counted in this item. Otherwise, count the additional hours of work participation in the work activity "Other Work Activities."

81. Other Work Activities

Guidance: Reporting on this data element is optional. States may want to demonstrate their additional efforts at helping individuals become self-sufficient even though these activities are not considered in the calculation of the work participation rates.

82. Required Hours of Work Under Waiver Demonstration:

Guidance: In approving waivers, ACF specified hours of participation in several instances. One type of hour change in the welfare reform demonstrations, was the recognition, as part of a change in work activities and/or exemptions, that the hours individuals worked should be consistent with their abilities and in compliance with an employability or personal responsibility plan or other criteria in accordance to waiver terms and conditions. As the hour requirement in this case was integral and necessary to achieve the waiver purpose of appropriately requiring work activities to move individuals to self-sufficiency, the State could show inconsistency and could use the waiver hours instead of the hours in section 407. A waiver that merely increased work hour requirements would not be deemed inconsistent.

Instruction: If applicable, enter the two-digit number that represents the average number of hours per week of work participation required of the individual as described in the demonstration terms or in an employability or personal responsibility plan. Otherwise, leave blank or enter "0."

Amount of Earned Income

Earned income has two categories. For each category of earned income, enter the dollar amount of the adult's (or minor child head-of-household's) earned income.

83. Earned Income Tax Credit (EITC):

Guidance: Earned Income Tax Credit is a refundable tax credit for families and dependent children. EITC payments are received either monthly (as advance payment through the employer), annually (as a refund from IRS), or both.

Instruction: Enter the total dollar amount of the earned income tax credit actually received, whether received as an advance payment or a single payment (e.g., tax refund), by the adult (minor child head-of-household) during the reporting month. If the State counts the EITC as a resource, report it here as earned income in the month received. If the State assumes an advance payment is applied for and obtained, only report what is actually received for this item.

84. Wages, Salaries, and Other Earnings:

Amount of Unearned Income

Unearned income has four categories. For each category of unearned income, enter the dollar amount of the adult's (or minor child head-of-household's) unearned income.

85. Social Security: Enter the dollar amount of Social Security that the adult in the State (Tribal) TANF family has received for the reporting month.

86. SSI: Enter the dollar amount of SSI that the adult in the State (Tribal) TANF family has received for the reporting month.

87. Worker's Compensation: Enter the dollar amount of Worker's Compensation that the adult in the State (Tribal) TANF family has received for the reporting month.

88. Other Unearned Income:

Guidance: Other unearned income includes (but is not limited to) RSDI benefits, Veterans benefits, Unemployment Compensation, other government benefits, housing subsidy, contribution/income-in-kind, deemed income, Public Assistance or General Assistance, educational grants/scholarships/loans, other. Do not include Social Security, SSI, Worker's Compensation, value of Food Stamps assistance, the amount of the Child Care subsidy, and the amount of Child Support.

Instruction: Enter the dollar amount of other unearned income that the adult in the State TANF family has received for the reporting month.

Child Characteristics

This section allows for coding up to ten children in the TANF family. A minor child head-of-household should be coded as an adult, not as a child. The youngest child should be coded as the first child in the family, the second youngest child as the second child, and so on. If the needs of an unborn child are included in the amount of assistance provided to the family, code the unborn child as one of the children. Do this by entering the Date-of-Birth as "99999999" and leave the other Child Characteristics fields blank.

If there are more than ten children in the TANF family, use the following order to identify the persons to be coded: (1) children in the eligible family receiving assistance in order from youngest to oldest; (2) minor siblings of child in the eligible family receiving assistance from youngest to oldest; and (3) any other children.

89. Family Affiliation:

Instruction: Enter the one-digit code that shows the Child's relation to the eligible family receiving assistance.

1 = Member of the eligible family receiving assistance

Not in eligible family receiving assistance, but in the household

2 = Parent of minor child in the eligible family receiving assistance

3 = Caretaker relative of minor child in the eligible family receiving assistance

4 = Minor sibling of child in the eligible family receiving assistance

5 = Person whose income or resources are considered in determining eligibility for or amount of assistance for the eligible family receiving assistance

90. Date of Birth: Enter the eight-digit code for date of birth for this child under the State (Tribal) TANF Program in the format YYYYMMDD.

91. Social Security Number: Enter the nine-digit Social Security Number for the child in the format nnnnnnnnn.

92. Race: Enter the one-digit code for the race of the TANF child.

1 = White, not of Hispanic origin

2 = Black, not of Hispanic origin

3 = Hispanic

4 = American Indian or Alaska Native

5 = Asian or Pacific Islander

6 = Other

9 = Unknown

93. Gender: Enter the one-digit code that indicates the child's gender.

1 = Male

2 = Female

Receives Disability Benefits

The Act specifies five types of disability benefits. Two of these types of disability benefits are applicable to children. For each type of disability benefits, enter the one-digit code that indicates whether or not the child received the benefit.

94. Receives Benefits Based on Federal Disability Status: Enter the one-digit code that indicates the child received benefits based on Federal disability status for the reporting month.

1 = Yes, received benefits based on Federal disability status

2 = No

95. Receives Aid Under Title XVI-SSI: Enter the one-digit code that indicates the child received aid under a State plan approved under Title XVI-SSI for the reporting month.

1 = Yes, received aid under Title XVI-SSI

2 = No

96. Relationship to Head-of-Household:

Instruction: Enter the two-digit code that shows the child's relationship (including by marriage) to the head of the household, as defined by the Food Stamp Program or as determined by the State (Tribe), (i.e., the relationship to the principal person of each person living in the household.)

01 = Head-of-household

02 = Spouse

03 = Parent

04 = Daughter or son

05 = Stepdaughter or stepson

06 = Grandchild or great grandchild

07 = Other related person (brother, niece, cousin)

08 = Foster child

09 = Unrelated child

10 = Unrelated adult

97. Teen Parent With Child In the Family:

Guidance: A teen parent is a person who is under 20 years of age and that person's child is also a member of the TANF family.

Instruction: Enter the one-digit code that indicates the child's teen parent status.

1 = Yes, a teen parent

2 = No

Educational Level

Educational level is divided into two parts: the highest level of education attained and the highest degree attained.

98. Highest Level of Education Attained: Enter the two-digit code to indicate the highest level of education attained by the child.

00 = no formal education

01-12 = Grade level completed in primary/secondary school including secondary level vocational school or adult high school

99. Highest Degree Attained:

Instruction: If the child has a degree(s), enter the one-digit code that indicates the child's highest degree attained. Otherwise, leave the field blank.

0 = No degree

1 = High school diploma, GED, or National External Diploma Program

2 = Awarded Associate's Degree

3 = Awarded Bachelor's Degree

4 = Awarded graduate degree (Master's or higher)

5 = Other credentials (degree, certificate, diploma, etc.)

9 = Not applicable

100. Citizenship/Alienage: Enter the two-digit code that indicates the child's citizenship/alienage. The coding for this data element is the same as for item number 0, on page 487.

101. Cooperation with Child Support: Enter the one-digit code that indicates this child's parent has cooperated with child support for this child.

1 = Yes, child's parent has cooperated with child support

2 = No

3 = Not applicable

Amount of Unearned Income

Unearned income has two categories. For each category of unearned income, enter the dollar amount of the child's unearned income.

102. SSI: Enter the dollar amount of SSI that the child in the State (Tribal) TANF family has received for the reporting month.

103. Other Unearned Income: Enter the dollar amount of other unearned income that the child in the State (Tribal) TANF family has received for the reporting month.

Child Care Reporting Section

Complete this section for each child in the TANF family for which a TANF child care subsidy is received (i.e., funded under the State or Tribal TANF Program). If child care is provided by more than one provider, enter the child care data for the greatest number of hours on the Primary Care line, and the next highest number of child care hours on the Secondary Care line.

104. Type of Child Care:

Definition: Provider types are divided into two broad categories of licensed/regulated and legally operating (no license category available in State or locality). Under each of these categories are four types of providers: in-home, family home, group home, and centers. A relative provider is defined as one who is at least 18 years of age and who is a grandparent, great-grandparent, aunt or uncle, or sibling living outside the child's home.

Instruction: Enter the two-digit code indicating the type of care for each child. The following codes specify who cared for the child and where such care took place during the reporting month.

01 = Licensed/regulated in-home child care

02 = Licensed/regulated family child care

03 = Licensed/regulated group home child care

04 = Licensed/regulated center-based child care

05 = Legally operating (no license category available in State or locality) in-home child care provided by a non-relative

06 = Legally operating (no license category available in State or locality) in-home child care provided by a relative

07 = Legally operating (no license category available in State or locality) family child care provided by a non-relative.

08 = Legally operating (no license category available in State or locality) family child care provided by a relative

09 = Legally operating (no license category available in State or locality) group child care provided by a non-relative

10 = Legally operating (no license category available in State or locality) group child care provided by a relative

11 = Legally operating (no license category available in State or locality) center-based child care

A. Primary B. Secondary

105. Total Monthly Cost of Child Care: For each child receiving child care, enter the total dollar amount (round to the nearest dollar) that the provider charges for the service. Include both the fee the family pays and the child care subsidy.

A. Primary B. Secondary

106. Total Monthly Hours of Child Care Provided During the Reporting Month: Enter the three-digit number for the total monthly number of child care hours provided for the reporting month.

States (Tribes) may use their own formula to estimate the number of child care hours provided. If the State payment system is based on daily or part day rates, the calculated number of hours of service would be based on the number of full or part days given in each week (as defined by the State) multiplied by the number of hours for the full or part day. The calculated number should be reported as the actual number of hours provided.

Example:

Full day = 8 hours

Part day = 5 hours

Care given = 3 full days and 2 part days

Average hours of care provided = (3*8 + 2*5) = 34

A. Primary B. Secondary

APPENDIX B

TANF Data Report - Section Two

Disaggregated Data Collection for Families

No Longer Receiving Assistance under the TANF Program

Instructions and Definitions

General Instruction: The State agency or Tribal grantee should collect and report data for each data element, unless explicitly instructed to leave the field blank.

2. County FIPS Code: Enter the three-digit code established by the National Institute of Standards and Technology for classification of counties and county equivalents. Codes were devised by listing counties alphabetically and assigning sequentially odd integers; e.g., 001, 003, 005, . . . . A complete list of codes is available in Appendix F of the TANF Sampling and Statistical Methods Manual. Tribal grantees should leave this field blank.

4. Reporting Month: Enter the four-digit year and two-digit month code that identifies the year and month for which the data are being reported.

5. Stratum:

Guidance: All families selected in the sample from the same stratum must be assigned the same stratum code. Valid stratum codes may range from "00" to "99." States and Tribes with stratified samples should provide the ACF Regional Office with a listing of the numeric codes utilized to identify any stratification. If a State or Tribe uses a non-stratified sample design or opts to provide data for its entire caseload, enter the same stratum code any two-digit number) for each family.

Instruction: Enter the two-digit stratum code.

Family-Level Data

(1) Parent(s) or caretaker relative(s) of any minor child receiving assistance;

(2) Minor siblings (including unborn children) of any child receiving assistance; and

(3) Any person whose income or resources would be counted in determining the family's eligibility for or amount of assistance.

6. Case Number - TANF:

Guidance: If the case number is less than the allowable eleven characters, a State may use lead zeros to fill in the number.

Instruction: Enter the number that was assigned by the State agency or Tribal grantee to uniquely identify the TANF family.

7. ZIP Code: Enter the five-digit ZIP code for the family's place of residence for the reporting month.

8. Disposition: Enter one of the following codes for each TANF family.

1 = Data collection completed

2 = Not subject to data collection/listed in error

9. Reason for Closure:

Guidance: A closed case is a family whose assistance was terminated for the reporting month, but received assistance under the State's TANF Program in the prior month. A temporally suspended case is not a closed case. If there is more than one applicable reason for closure, determine the principal (i.e., most relevant) reason. If two or more reasons are equally relevant, use the reason with the lowest numeric code.

Instruction: Enter the one-digit code that indicates the reason for the TANF family no longer receiving assistance.

1 = Employment

2 = Marriage

3 = Five-Year Time Limit

4 = Sanction

5 = State (Tribal) policy

6 = Minor child absent from the home for a significant time period

7 = Transfer to Separate State MOE Program

8 = Other

10. Number of Family Members: Enter two digits that represent the number of members in the family, which received assistance under the State's (Tribe's) TANF Program.

11. Receives Subsidized Housing:

Instruction: Enter the one-digit code that indicates whether or not the TANF family received subsidized housing for the reporting month.

1 = Public housing

2 = HUD rent subsidy

3 = Other rent subsidy

4 = No housing subsidy

12. Receives Medical Assistance: Enter "1" if, for the reporting month, any TANF family member is eligible to receive (i.e., a certified recipient of) medical assistance under the State plan approved under Title XIX or "2" if no TANF family member is eligible to receive medical assistance under the State plan approved under Title XIX.

1 = Yes, receives medical assistance

2 = No

13. Receives Food Stamps: If the TANF family received Food Stamps for the sample month, enter the one-digit code indicating the type of Food Stamp assistance. Otherwise, enter "4."

1 = Yes, Food Stamp coupon allotment

2 = Yes, cash

3 = Yes, wage subsidy

4 = No

14. Amount of Food Stamp Assistance:

Guidance: For situations in which the Food Stamp household differs from the TANF family, code this element in a manner that most accurately reflects the resources available to the TANF family.

Instruction: Enter the TANF family's authorized dollar amount of Food Stamp assistance for the reporting month.

15. Receives Subsidized Child Care:

Guidance: For the purpose of coding this data element, subsidized child care funded under the Child Care and Development Fund with funds that were transferred from the State TANF Program should be coded as "2."

Instruction: If the TANF family receives subsidized child care for the reporting month, enter code "1", "2", "3", or "4", whichever is appropriate. Otherwise, enter code "5."

1 = Yes, funded under the State (Tribal) TANF Program

2 = Yes, funded under the Child Care and Development Fund

3 = Yes, funded under another Federal program (e.g., SSBG)

4 = Yes, funded under a State, Tribal, or local program

5 = No

16. Amount of Subsidized Child Care:

Person-Level Data

Adult and Minor Child Head-of-Household Characteristics

This section allows for coding up to six adults (or a minor child head-of-household and up to five adults) in the TANF family. A minor child head-of-household should be coded as an adult. For each adult (or minor child head-of-household) in the TANF family, complete the adult characteristics section. If a noncustodial parent is participating in work activities funded under the State (Tribal) TANF Program for the reporting month, the noncustodial parent must also be reported in this section as a member of the family receiving assistance.

17. Family Affiliation:

Instruction: Enter the one-digit code that shows the adult's relation to the eligible family receiving assistance.

1 = Member of the eligible family receiving assistance

Not in eligible family receiving assistance, but in the household

2 = Parent of minor child in the eligible family receiving assistance

3 = Caretaker relative of minor child in the eligible family receiving assistance

4 = Minor sibling of child in the eligible family receiving assistance

5 = Person whose income or resources are considered in determining eligibility for or amount of assistance for the eligible family receiving assistance

18. Date of Birth: Enter the eight-digit code for date of birth for this adult (or minor child head-of-household) under TANF in the format YYYYMMDD.

19. Social Security Number: Enter the nine-digit Social Security Number for the adult (or minor child head-of-household) in the format nnnnnnnnn.

20. Race: Enter the one-digit code for the race of the TANF adult (or minor child head-of-household).

1 = White, not of Hispanic origin

2 = Black, not of Hispanic origin

3 = Hispanic

4 = American Indian or Alaska Native

5 = Asian or Pacific Islander

6 = Other

9 = Unknown

21. Gender: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) gender.

1 = Male

2 = Female

Receives Disability Benefits

22. Receives Federal Disability Insurance Benefits: Enter the one-digit code that indicates the adult (or minor child head-of-household) received Federal disability insurance benefits for the reporting month.

1 = Yes, received Federal disability insurance

2 = No

23. Receives Benefits Based on Federal Disability Status: Enter the one-digit code that indicates the adult (or minor child head-of-household) received benefits based on Federal disability status for the reporting month.

1 = Yes, received benefits based on Federal disability status

2 = No

24. Receives Aid Under Title XIV-APDT: Enter the one-digit code that indicates the adult (or minor child head-of-household) received aid under a State plan approved under Title XIV for the reporting month.

1 = Yes, received aid under Title XIV-APDT

2 = No

25. Receives Aid Under Title XVI-AABD: Enter the one-digit code that indicates the adult (or minor child head-of-household) received aid under a State plan approved under Title XVI-AABD for the reporting month.

1 = Yes, received aid under Title XVI-AABD

2 = No

26. Receives Aid Under Title XVI-SSI: Enter the one-digit code that indicates the adult (or minor child head-of-household) received aid under a State plan approved under Title XVI-SSI for the reporting month.

1 = Yes, received aid under Title XVI-SSI

2 = No

27. Marital Status: Enter the one-digit code for the marital status of the recipient.

1 = Single, never married

2 = Married, living together

3 = Married, but separated

4 = Widowed

5 = Divorced

28. Relationship to Head-of-Household:

Instruction: Enter the two-digit code that shows the adult's relationship (including by marriage) to the head of the household, as defined by the Food Stamp Program or as determined by the State (Tribe), (i.e., the relationship to the principal person of each person living in the household.) If a minor child head-of-household, enter code "01."

01 = Head of household

02 = Spouse

03 = Parent

04 = Daughter or son

05 = Stepdaughter or stepson

06 = Grandchild or great grandchild

07 = Other related person (brother, niece, cousin)

08 = Foster child

09 = Unrelated child

10 = Unrelated adult

29. Teen Parent With Child In the Family:

Guidance: A teen parent is a person who is under 20 years of age and that person's child is also a member of the TANF family.

Instruction: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) teen parent status.

1 = Yes, a teen parent

2 = No

Educational Level

Educational level is divided into two parts: the highest level of education attained and the highest degree attained.

30. Highest Level of Education Attained: Enter the two-digit code to indicate the highest level of education attained by the adult (or minor child head-of-household).

00 = No formal education

01-12 = Grade level completed in primary/secondary school including secondary level vocational school or adult high school

31. Highest Degree Attained: If the adult (or minor child head-of-household) has a degree(s), enter the one-digit code that indicates the adult's (or minor child head-of-household's) highest degree attained. Otherwise, leave the field blank.

0 = No degree

1 = High school diploma, GED, or National External Diploma Program

2 = Awarded Associate's Degree

3 = Awarded Bachelor's Degree

4 = Awarded graduate degree (Master's or higher)

5 = Other credentials (degree, certificate, diploma, etc.)

32. Citizenship/Alienage:

Instruction: Enter the two-digit code that indicates the adult's (or minor child head-of-household's) citizenship/alienage.

Individuals Eligible for the TANF Program

01 = U.S. citizen, including naturalized citizens

03 = Qualified alien accorded refugee, Cuban or Haitian entrant, or Amerasian immigrant status (INS Form I-94) who has resided in the U.S. five years or less

Individuals Eligible for the TANF Program at State Option

06 = Qualified alien accorded refugee, Cuban or Haitian entrant, or Amerasian immigrant status (INS Form I-94) who has resided in the U.S. more than five years

07 = Qualified alien granted political asylum or granted withholding of deportation by INS (under sec. 243(h) or sec. 241(b)(3) of the INA) more than five years ago;

Individuals Not Eligible for the TANF Program

09 = Any alien who is not a qualified alien.

Status Unknown

99 = Unknown

33. Number of Months Countable toward Federal Time Limit in Own State (Tribe): Enter the number of months countable toward the adult's (or minor child head-of-household's) Federal five-year time limit based on assistance received from the State (Tribe).

34. Number of Months Countable toward Federal Time Limit in Other States or Tribes: Enter the number of months countable toward the adult's (or minor child head-of-household's) Federal five-year time limit based on assistance received from other States or Tribes.

35. Number of Countable Months Remaining Under State's (Tribe's) Time Limit: Enter the number of months that remain countable toward the adult's (or minor child head-of-household's) State (Tribal) time limit.

36. Employment Status: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) employment status.

1 = Employed

2 = Unemployed, looking for work

3 = Not in labor force (i.e, unemployed, not looking for work, includes discouraged workers)

Amount of Earned Income

For each category of earned income, enter the amount of the adult's (or minor child head-of-household's) earned income.

37. Earned Income Tax Credit (EITC):

38. Wages, Salaries, and Other Earnings:

Amount of Unearned Income

39. Unearned Income: Enter the amount of the adult's (or minor child head-of-household's) unearned income.

Child Characteristics

40. Family Affiliation:

Instruction: Enter the one-digit code that shows the Child's relation to the eligible family receiving assistance.

1 = Member of the eligible family receiving assistance

Not in eligible family receiving assistance, but in the household

2 = Parent of minor child in the eligible family receiving assistance

3 = Caretaker relative of minor child in the eligible family receiving assistance

4 = Minor sibling of child in the eligible family receiving assistance

5 = Person whose income or resources are considered in determining eligibility for or amount of assistance for the eligible family receiving assistance

41. Date of Birth: Enter the eight-digit code for date of birth for this child under TANF in the format YYYYMMDD.

42. Social Security Number: Enter the nine-digit Social Security Number for the child in the format nnnnnnnnn.

43. Race: Enter the one-digit code for the race of the TANF child.

1 = White, not of Hispanic origin

2 = Black, not of Hispanic origin

3 = Hispanic

4 = American Indian or Alaska Native

5 = Asian or Pacific Islander

6 = Other

9 = Unknown

44. Gender: Enter the one-digit code that indicates the child's gender.

1 = Male

2 = Female

Receives Disability Benefits

45. Receives Benefits Based on Federal Disability Status: Enter the one-digit code that indicates the child received benefits based on Federal disability status for the reporting month.

1 = Yes, received benefits based on Federal disability status

2 = No

46. Receives Aid Under Title XVI-SSI: Enter the one-digit code that indicates the child received aid under a State plan approved under Title XVI-SSI for the reporting month.

1 = Yes, received aid under Title XVI-SSI

2 = No

47. Relationship to Head-of-Household:

01 = Head of household

02 = Spouse

03 = Parent

04 = Daughter or son

05 = Stepdaughter or stepson

06 = Grandchild or great grandchild

07 = Other related person (brother, niece, cousin)

08 = Foster child

09 = Unrelated child

10 = Unrelated adult

48. Teen Parent With Child In the Family:

Guidance: A teen parent is a person who is under 20 years of age and that person's child is also a member of the TANF family.

Instruction: Enter the one-digit code that indicates the child's teen parent status.

1 = Yes, a teen parent

2 = No

Educational Level

Educational level is divided into two parts: the highest level of education attained and the highest degree attained.

49. Highest Level of Education Attained: Enter the two-digit code to indicate the highest level of education attained by the child.

00 = No formal education

01-12 = Grade level completed in primary/secondary school including secondary level vocational school or adult high school

50. Highest Degree Attained:

Instruction: If the child has a degree(s), enter the one-digit code that indicates the child's highest degree attained. Otherwise, leave the field blank.

0 = No degree

1 = High school diploma, GED, or National External Diploma Program

2 = Awarded Associate's Degree

3 = Awarded Bachelor's Degree

4 = Awarded graduate degree (Master's or higher)

5 = Other credentials (degree, certificate, diploma, etc.)

9 = Not applicable

51. Citizenship/Alienage: Enter the two-digit code that indicates the child's citizenship/alienage. The coding for this data element is the same as for item number 0, on page 504.

52. Cooperation with Child Support: Enter the one-digit code that indicates whether this child's parent has cooperated with child support for this child.

1 = Yes, child's parent has cooperated with child support

2 = No, child's parent has not cooperated with child support

3 = Not applicable

53. Unearned Income: Enter the dollar amount of the child's unearned income.

APPENDIX C

TANF Data Report - Section Three

Aggregated Data Collection for

Families Applying for, Receiving, and

No Longer Receiving Assistance under the TANF Program

Instructions and Definitions

1. State FIPS Code: Enter your two-digit State code. Tribal grantees should leave this field blank.

2. Tribal Code: For Tribal grantees only, enter the three-digit Tribal code that represents your Tribe (See Appendix E of the TANF Sampling and Statistical Methods Manual for a complete listing of Tribal Codes). State agencies should leave this field blank.

3. Calendar Quarter: The four calendar quarters are as follows:

First quarter .....January - March

Second quarter.... April - June

Third quarter......July - September

Fourth quarter.....October - December

Enter the four-digit year and one-digit quarter code (in the format YYYYQ) that identifies the calendar year and quarter for which the data are being reported (e.g., first quarter of 1997 is entered as "19971").

APPLICATIONS

Guidance: The term "application" means the action by which an individual indicates in writing to the agency administering the State (or Tribal) TANF Program his/her desire to receive assistance.

Instruction: All counts of applications should be unduplicated monthly totals.

4. Total Number of Applications: Enter the total number of approved and denied applications received for each month of the quarter. For each month in the quarter, the total in this item should equal the sum of the number of approved applications (in item #5) and the number of denied applications (in item #6).

A. First Month: B. Second Month: C. Third Month:

5. Total Number of Approved Applications: Enter the number of applications approved during each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

6. Total Number of Denied Applications: Enter the number of applications denied (or otherwise disposed of) during each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

ACTIVE CASES

For purposes of completing this report, include all TANF eligible cases receiving assistance (i.e., cases funded under the TANF block grant and State MOE funded TANF cases) as cases receiving assistance under the State (Tribal) TANF Program. All counts of families and recipients should be unduplicated monthly totals.

7. Total Amount of Assistance: Enter the dollar value of all assistance (cash and non-cash) provided to TANF families under the State (Tribal) TANF Program for each month of the quarter. Round the amount of assistance to the nearest dollar.

A. First Month: B. Second Month: C. Third Month:

8. Total Number of Families: Enter the number of families receiving assistance under the State (Tribal) TANF Program for each month of the quarter. The total in this item should equal the sum of the number of two-parent families (in item #9), the number of one-parent families (in item #10) and the number of no-parent families (in item #11).

A. First Month: B. Second Month: C. Third Month:

9. Total Number of Two-parent Families: Enter the total number of 2-parent families receiving assistance under the State (Tribal) TANF Program for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

10. Total Number of One-Parent Families: Enter the total number of one-parent families receiving assistance under the State (Tribal) TANF Program for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

11. Total Number of No-Parent Families: Enter the total number of no-parent families receiving assistance under the State (Tribal) TANF Program for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

12. Total Number of Recipients: Enter the total number of recipients receiving assistance under the State (Tribal) TANF Program for each month of the quarter. The total in this item should equal the sum of the number of adult recipients (in item #13) and the number of child recipients (in item #14).

A. First Month: B. Second Month: C. Third Month:

13. Total Number of Adult Recipients: Enter the total number of adult recipients receiving assistance under the State (Tribal) TANF Program for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

14. Total Number of Child Recipients: Enter the total number of child recipients receiving assistance under the State (Tribal) TANF Program for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

15. Total Number of Non-Custodial Parents Participating in Work Activities: Enter the total number of non-custodial parents participating in work activities under the State (Tribal) TANF Program for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

16. Total Number of Minor Child Heads-of-Household: Enter the total number of minor child head-of-household families receiving assistance under the State (Tribal) TANF Program for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

17. Total Number of Births: Enter the total number of births for families receiving assistance under the State (Tribal) TANF Program for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

18. Total Number of Out-of-Wedlock Births: Enter the total number of out-of-wedlock births for families receiving assistance under the State (Tribal) TANF Program for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

CLOSED CASES

19. Total Number of Closed Cases: Enter the total number of closed cases for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

APPENDIX D

Department of Health and Human Services
Administration for Children and Families

Temporary Assistance for Needy Families (TANF) ACF - 196 Financial Report

STATE FISCAL CURRENT QTR. ENDED NEXT QTR. ENDING ANNUAL RECONCILIATION
[ ] YES [ ] NO

ITEMS
(A)

FEDERAL AWARDS &
TRANSFERS

SFAG FUNDS

(B)

(C)

CONTINGENCY FUND
FEDERAL SHARE AT FY
1995 FMAP RATE OF
______%

(D)

FEDERAL AWARDS

1. AWARDED $ $

2. TRANSFERRED TO CCDF DISCRETIONARY $

3. TRANSFERRED TO SSBG $

4. AVAILABLE FOR TANF $

FEDERAL TANF
EXPENDITURES STATE TANF
EXPENDITURES (MOE) SEPARATE STATE
PROGRAMS (MOE) FEDERAL
EXPENDITURES

5. EXPENDITURES ON ASSISTANCE $ $ $ $

a. CASH ASSISTANCE
$ $ $ $

b. WORK SUBSIDIES
$ $ $ $

c. CHILD CARE
$ $ $ $

d. OTHER
$ $ $ $

6. EXPENDITURES ON NON-ASSISTANCE $ $ $ $

a. WORK ACTIVITIES
$ $ $ $

b. ADMINISTRATION
$ $ $ $

c. SYSTEMS
$ $ $ $

d. TRANSITIONAL SERVICES FOR EMPLOYED
$ $ $ $

e. OTHER
$ $ $ $

7. OTHER EXPENDITURES $ $ $ $

8. TOTAL EXPENDITURES $ $ $ $

9. FEDERAL UNLIQUIDATED OBLIGATIONS $ $

10. UNOBLIGATED BALANCE $ $

QUARTERLY ESTIMATE

TANF FEDERAL FUNDS

11. ESTIMATE FOR NEXT QTR. ENDED $

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.

SIGNATURE: AUTHORIZED STATE OFFICIAL
TYPED NAME, TITLE, AGENCY NAME

DATE SUBMITTED:
SUBMITTAL: [ ] NEW [ ] REVISED

PAGE 1 OF 1 APPROVED OMB NO. xxxx-xxxx FORM ACF-196 (xx/xx)

APPENDIX D - SECTION 2

INSTRUCTION FOR COMPLETION OF FORM ACF-196

Financial Reporting Form for the Temporary Assistance for

Needy Families (TANF) Program

All States must complete and submit this report in accordance with these instructions on behalf of the State agency administering the TANF Program.

Due Dates: This form must be submitted quarterly by

February 14, May 15, August 14 and November 14.

States must submit quarterly reports for each fiscal year until all Federal TANF funds are expended. A State may be submitting reports simultaneously to cover two or more fiscal years.

Distribution: The original copy (with original signatures) should be submitted to: Administration for Children and Families, Office of Program Support, Division of Formula, Entitlement and Block Grants, Aerospace Building, 7th Floor, 370 L'Enfant Promenade, S.W., Washington, D.C. 20447. An additional copy should be submitted to the ACF Regional Administrator.

General Instructions.

- Round all entries to the nearest dollar. Omit cents.

- Enter State Name

- Enter the Fiscal Year for which this report is being submitted. Funding for each fiscal year is available until expended. Therefore, for each fiscal year, a State may be submitting reports simultaneously to cover two or more fiscal years. It is important to indicate the year for which information is being reported.

- Enter the ending dates for the current quarter (the quarter just ended for which this constitutes the report of actual expenditures and obligations) and the ending date of the next quarter (the upcoming quarter for which estimates are being requested on line 11). Example: the State is reporting for the 1st quarter of the Federal fiscal year (10/1 through 12/31), the report is due February 14, the current quarter ending date is 12/31, the next quarter ending date for which estimates are requested is 6/30. The estimate submitted by the State will be for the quarter of 4/1 through 6/30. Estimates are not required on quarterly reports submitted for prior fiscal years.

- Enter whether this report is being used for annual reconciliation of the Contingency Fund.

- Enter the Federal Medical Assistance Percentage Rate used by the State for the fiscal year for which Contingency Funds were received.

- Indicate whether this is a new report or a revision of a report previously submitted for the same period.

- Entries are not required or are not applicable to blocks that are shaded.

Columns: All amounts reported in columns (A) through (D) must be actual expenditures or obligations made in accordance with all applicable statutes and regulations. Amounts reported in the estimates section are Federal estimates of expenditures to be made during the quarter indicated based on the best information available to the State.

Explanation of Columns:

Column (A) lines 1 through 4 refer to the Federal State Family Assistance Grant (SFAG) awards, amounts transferred to the Child Care and Development Fund (CCDF) (Discretionary Fund) and the Social Services Block Grant (SSBG) program, and the amount Available for TANF.

Column (A) lines 5 through 10 refer to the Federal SFAG funds the State expended and obligated under its TANF program.

Column (A) line 11 is the SFAG grant award amount or percentage the State estimates it will need for the next quarter ending referenced at the top of the form. (See page 6 of Line Item Instructions)

Column (B) lines 5 through 8 refer to State TANF expenditures the State is making to meet its TANF Maintenance of Effort (MOE) requirement. Includes State funds that are commingled with Federal funds; or State funds expended on the State program funded under TANF.

Note: States receiving Contingency Funds under section 403(b) for the fiscal year must also use this same column to report State TANF expenditures made to meet the Contingency Fund (CF) MOE requirement and matching expenditures made above the 100 percent MOE requirement. Expenditures made to meet the CF MOE requirement and expenditures made above the MOE level (for matching purposes) must be expenditures made under the State TANF program only; they cannot include expenditures made under "separate State programs." In addition, child care expenditures cannot be included as MOE expenditures or expenditures that are matched with Contingency Funds.

Column (C) lines 5 through 8 refer to State expenditures the State is making in Separate State Programs outside the State TANF program to meet its TANF MOE requirement.

Note: For the TANF MOE requirement, the cumulative total expenditures (Sum of 8(B) + 8(C)) reported at the end of the Federal fiscal year should add up to 75% of fiscal year 1994 historic State expenditures if the State met the TANF participation requirements, or 80% of fiscal year 1994 historic State expenditures if the State did not meet the TANF participation requirements. TANF MOE requirements and tables were published in Program Instruction No. TANF-ACF-PI-96-2, dated December 6, 1996.

For States that received Contingency Funds, line 8(B) minus line 5c(B) (child care) must exceed 100 percent of the CF MOE requirement.

Note: The State must submit an addendum attached to the fourth quarter report for each fiscal year that provides "separate State program" information as required under parts 273 and 274 of the proposed rules.

Column (D) line 1 refers to the Federal Contingency Fund grant awards.

Column (D) lines 5 through 10 refer to the Federal share of expenditures for which Federal funding is available at the FMAP rate for the fiscal year for which Contingency Funds were received. Contingency Funds are available for match for State expenditures in excess of 100% of CF MOE requirements as explained in the "Note" above.

Example: The State received Contingency Funds of $100,000 for 6 months of the fiscal year; the FMAP rate is 60% Federal and 40% State; the CF 100% MOE requirement is $1,000,000; the State reported expenditures under Columns (B) and (D) of $1,200,000. To determine how much of the Contingency Funds the State can keep, the expenditures of $1,000,000 (CF MOE requirement) must be subtracted from the total expenditures of $1,200,000. That difference ($200,000) is to be multiplied by 60 percent, i.e., $200,000 X 60% = $120,000. The $120,000 must then be multiplied by 1/12 times the number of months a State received Contingency Funds, i.e., $120,000 X 1/12 X 6 = $60,000. The State may keep only $60,000 of the $100,000 ACF awarded it for the Contingency Fund.

Determining how much, if any, a State can keep of the Contingency Funds awarded to it for a fiscal year, is known only after annual reconciliation of the Contingency Fund account is completed. This form will serve as the annual reconciliation report when submitted for the fourth quarter of the fiscal year. Based on the example above, line 8 of Column (D) (Total Expenditures-Contingency Fund) must equal $60,000.

It is possible that a State will have received Contingency Funds after the end of the fiscal year that apply to expenditures made in the prior fiscal year. For a State receiving Contingency Funds for a fiscal year after it has ended, the State will be required to submit a revised fourth quarter report within 45 days of receipt of the additional Contingency Funds. There is no carryover from one fiscal year to the next.

State Replacement of Grant Reductions Resulting from Penalties

If a State's State Family Assistance Grant is reduced because of the imposition of a penalty under section 409, section 409(a)(12) provides that the State must maintain a level of spending at the SFAG amount. In place of SFAG funds withheld for a penalty, the State must substitute with its own funds an amount that is no less than the amount withheld. The State replacement funds must be included in Column (B).

Line Item Instructions

Cumulative Fiscal Year Expenditures and Obligations

Line 1. Awarded. Enter in column (A) the cumulative total of State Family Assistance Grant (SFAG) funds awarded to the State from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported. Enter in column (D) the cumulative total of Contingency Funds awarded to the State from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported.

Line 2. Transferred to Child Care and Development Fund (CCDF). Enter in column (A) the cumulative total of funds the State transferred to the Discretionary Fund of the Child Care and Development Fund from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported. Section 404(d)(1) of the Act governs the transfer of SFAG funds to the Discretionary Fund. In compliance with section 404(d)(1), a State may not transfer more than 30% of its total annual SFAG grant. A State may transfer this entire amount to the Discretionary Fund of the CCDF program. All funds transferred to the Discretionary Fund of the CCDF program take on the rules and regulations of that recipient Fund.

Line 3. Transferred to SSBG. Enter in column (A) the cumulative total of funds the State transferred to the Social Services Block Grant (SSBG) program from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported. Section 404(d)(2) of the Act governs the transfer of SFAG funds to the SSBG program; it limits the amount a State may transfer to no more than 10% of its total annual SFAG to SSBG. (Also, the combined amount transferred to SSBG and the Discretionary Fund may not exceed 30% of the annual SFAG. In other words, for all financial reports applicable to grant funds for one fiscal year, the sum of the total cumulative amount reported on line 3 and the total cumulative amount reported on line 2 cannot exceed 30% of the annual SFAG.) All funds transferred to the SSBG program are subject to the statute and regulations of the recipient SSBG program.

Line 4. Available for TANF. Enter in column (A) the cumulative total of funds available for TANF after subtracting the amounts transferred to the CCDF program (Discretionary Fund) (line 2(A)) and/or the SSBG program (line 3(A)) from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported.

Line 5. Expenditures on Assistance. Blocks are shaded. Expenditures in this category must be included in Lines 5a. through 5d.

Line 5a. Cash Assistance. Enter in columns (A),(B),(C) and (D) the cumulative total expenditures for cash assistance from

October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported.

Line 5b. Work Subsidies. Enter in columns (A),(B),(C) and (D) the cumulative total expenditures for work subsidies from

October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported.

Line 5c. Child Care. Enter in columns (A),(B),(C) and (D) the cumulative total expenditures for child care from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported. The amounts reported in this category do not include funds transferred to the CCDF (Discretionary Fund) or SSBG programs.

Line 5d. Other. Enter in columns (A),(B),(C) and (D) the cumulative total expenditures for other expenditures considered "expenditures on assistance" that were not included on Lines 5a-5c from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported.

Note: The State must submit as an addendum attached to the fourth quarter report for each fiscal year which identifies the activities for which the "other expenditures" under this line item applies.

Line 6. Expenditures on Non-Assistance. Blocks are shaded. Expenditures in this category must be included in Lines 6a through 6e.

Line 6a. Work Activities. Enter in columns (A),(B),(C) and (D) the cumulative total expenditures for work activities from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported.

Note: The State must submit as an addendum attached to the fourth quarter report for each fiscal year (or more frequently, if there are changes) the State's definition of each work activity.

Line 6b. Administration. Enter in columns (A),(B),(C) and (D) the cumulative total expenditures for administrative costs from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported.

For State Family Assistance Grants (SFAG), the 15% administrative cost cap applies to the amount Available for TANF reported on line 4(A) of this form. For the Contingency Fund, the 15% administrative cost cap applies to the amount of total Federal expenditures reported on line 8(D). For State expenditures reported in columns (B) and (C), the 15% administrative cost cap applies to the amount of Total Expenditures (line 8) reported for each of these columns.

Line 6c. Systems. Enter in columns (A),(B),(C) and (D) the cumulative total expenditures for systems costs from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported.

Note: Section 404(b)(1) of the Act limits States to which a grant is made under section 403 to expend no more than 15% of the grant for administrative costs. In addition, section 404(b)(2) of the Act states that the 15% administrative cost cap shall not apply to the use of a grant for information technology and computerization needed for tracking or monitoring required by or under this part.

Line 6d. Transitional Services for Employed. Enter in columns (A),(B),(C) and (D) the cumulative total expenditures to provide transitional services to families that cease to receive assistance under the TANF program because of employment from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported.

Note: The State must submit as an addendum attached to the

fourth quarter report for each fiscal year which describes the types of services the State provided under this line item.

Line 6e. Other. Enter in columns (A),(B),(C) and (D) the cumulative total expenditures for other expenditures considered "expenditures on non-assistance" that were not included on Lines 6a-6d. from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported.

Line 7. Other Expenditures. Enter in columns (A), (B), (C) and (D) the cumulative total other expenditures from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported. "Other expenditures" are those expenditures that cannot be reported under any other category on this form.

Line 8. Total Expenditures. Enter in columns (A), (B), (C) and (D) the cumulative total expenditures (Sum of Line 5a through Line 7) from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported.

Line 9. Federal Unliquidated Obligations. Enter in columns (A) and (D) the cumulative total Federal unliquidated obligations from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported.

For the Contingency Fund, this line should indicate $0 for the report submitted for the fourth quarter.

Line 10. Unobligated Balance. Enter in columns (A) and (D) the cumulative total Federal unobligated balances from October 1 of the Federal fiscal year for which the report is being submitted through the current quarter being reported. After the end of the Federal fiscal year any amount reported in column (D) as an unobligated balance will be de-obligated by ACF.

Line 11. Estimate for Next Quarter Ended. Enter in column (A) the estimate of SFAG grant award funds requested for the next quarter ending (refer to the next quarter ending entered at the top of this report).

Note: Section 405(c)(1) of the Act states ACF shall estimate the amount to be paid to each eligible State for each quarter, such estimate is to be based on a report filed by the State containing an estimate by the State of the total sum to be expended by the State in the quarter under the State program funded under section 403.

APPENDIX D - SECTION 3

Information to be Reported as an Addendum to the Fourth Quarter

TANF Financial Report

A. The following definitions and information with respect to the TANF program:

(1) The number of cases excluded from the overall work participation rate, the two-parent work participation rate, and the time-limit calculations because of the State's definition of "families receiving assistance," together with an explanation of the basis for such exclusions;

(2) The State's definition of each work activity;

(3) A description of the transitional services provided to families no longer receiving assistance due to employment; and

(4) The State's description of how it will reduce the amount of assistance otherwise payable to the family prorata (or more) with respect to any period during a month in which the individual refuses to engage in work without good cause.

B. The following information on separate State programs whose expenditures are counted by the State as MOE:

(1) A description of the specific program activities provided to eligible families;

(2) Each MOE program's statement of purpose (i.e., how the program activity serves eligible families);

(3) The applicable definitions of each work activity;

(4) Whether the program activity had been previously authorized and allowable as of August 21, 1996, under section 403 of prior law;

(5) The FY 1995 State expenditures for each program activity not authorized and allowable as of August 21, 1996;

(6) The total number of eligible families served by each program activity as of the end of the fiscal year;

(7) The eligibility criteria for the families served under each program; and

(8) A certification that those families served met the

State's criteria for eligible families.

APPENDIX E

TANF MOE Data Report - Section One

Disaggregated Data Collection

for Families Receiving Assistance

under the Separate State Programs

Instructions and Definitions

General Instruction: The State agency should collect and report data for each data element shown below.

State FIPS Code: Enter your two-digit State code from the following listing. These codes are the standard codes used by the National Institute of Standards and Technology.

2. County FIPS Code: Enter the three-digit code established by the National Institute of Standards and Technology for classification of counties and county equivalents. Codes were devised by listing counties alphabetically and assigning sequentially odd integers; e.g., 001, 003, 005, . . . . A complete list of codes is available in Appendix F of the TANF Sampling and Statistical Methods Manual.

3. Reporting Month: Enter the four-digit year and two-digit month code that identifies the year and month for which the data are being reported.

4. Stratum:

Guidance: All families that receive assistance under separate State Programs (i.e, State MOE families) and are selected in the sample from the same stratum must be assigned the same stratum code. Valid stratum codes may range from "00" to "99." States with stratified samples should provide the ACF Regional Office with a listing of the numeric codes utilized to identify any stratification. If a State opts to provide data for its entire caseload, enter the same stratum code (any two-digit number) for each State MOE family.

Instruction: Enter the two-digit stratum code.

Family-Level Data

Definition: For reporting purposes, the State MOE family means (a) all individuals receiving assistance as part of a family under the Separate State Programs; and (b) the following additional persons living in the household, if not included under (a) above:

(1) Parent(s) or caretaker relative(s) of any minor child receiving assistance;

(2) Minor siblings (including unborn children) of any child receiving assistance; and

(3) Any person whose income or resources would be counted in determining the family's eligibility for or amount of assistance.

5. Case Number - Separate State MOE:

Guidance: If the case number is less than the allowable eleven characters, a State may use lead zeros to fill in the number.

Instruction: Enter the number assigned by the State agency to uniquely identify the case.

6. ZIP Code: Enter the five-digit ZIP code for the State MOE family's place of residence for the reporting month.

7. Disposition:

Instruction: Enter one of the following codes for each State MOE sampled case.

1 = Data collection completed

2 = Not subject to data collection/listed in error

8. Number of Family Members: Enter two digits that represent the number of members in the family receiving assistance under the Separate State Programs.

9. Type of Family for Work Participation:

Instruction: Enter the one-digit code that represents the type of family for purposes of calculating the work participation rates.

1 = Single-Parent Family for participation rate purposes

2 = Two-Parent Family for participation rate purposes

3 = No Parent Family for participation rate purposes (does not include parents, care-taker relatives, or minor child heads-of-household

10. Has the family received assistance under a State (Tribal) TANF Program within the past six months: If the State MOE family has received assistance under a State (Tribal) TANF Program within the past six months, enter code "1." Otherwise, enter "2."

1 = Yes, family has received assistance under a State (Tribal) TANF program within the past six months.

2 = No

11. Receives Subsidized Housing:

Instruction: Enter the one-digit code that indicates whether or not the State MOE family received subsidized housing for the reporting month.

1 = Public housing

2 = HUD rent subsidy

3 = Other rent subsidy

4 = No Housing subsidy

12. Receives Medical Assistance: Enter "1" if, for the reporting month, any State MOE family member is eligible to receive (i.e., a certified recipient of) medical assistance under the State plan approved under Title XIX or "2" if no State MOE family member is eligible to receive medical assistance under the State plan approved under Title XIX.

1 = Yes, receives Medical Assistance

2 = No

13. Receives Food Stamps: If the State MOE family received Food Stamps for the reporting month, enter the one-digit code indicating the type of Food Stamp assistance. Otherwise, enter "4."

1 = Yes, Food Stamp coupon allotment

2 = Yes, cash

3 = Yes, wage subsidy

4 = No

14. Amount of Food Stamp Assistance:

Guidance: For situations in which the Food Stamp household differs from the State MOE family, code this element in a manner that most accurately reflects the resources available to the State MOE family.

Instruction: Enter the State MOE eligible family's authorized dollar amount of Food Stamps assistance for the reporting month. If the State MOE family did not receive any food stamps for the reporting month, enter "0."

15. Receives Subsidized Child Care:

Instruction: If the State MOE family receives subsidized child care for the reporting month, enter code "1", "2", "3", or "4", whichever is appropriate. Otherwise, enter code "5."

1 = Yes, funded under the Separate State Programs

2 = Yes, funded under the Child Care and Development Fund

3 = Yes, funded under other Federal program (e.g., TANF or SSBG)

4 = Yes, funded under other State or local program

5 = No

16. Amount of Subsidized Child Care:

Instruction: Enter the dollar amount of subsidized child care that the State MOE family has received for services in the reporting month. If State MOE family did not receive any subsidized child care, enter "0" as the amount.

17. Amount of Child Care Disregard: Enter the total dollar amount of the State MOE family's actual disregard allowed for child care expenses.

18. Amount of Child Support: Enter the total dollar value of child support received on behalf of the State MOE family in the reporting month, which includes arrearages, recoupments, and pass-through amounts whether paid to the State or the family.

19. Amount of the Families' Cash Resources Enter the total dollar amount of the State MOE family's cash resources for the reporting month.

Amount of Assistance Received and the Number of Months that the Family Has Received Each Type of Assistance under the Separate State Programs

Guidance: Assistance means every form of support provided to State MOE families under the Separate State Program (including child care, work subsidies, and allowances to meet living expenses), except for the following:

(1) services that have no direct monetary value to an individual family and that do not involve implicit or explicit income support, such as counseling, case management, peer support and employment services that do not involve subsidies or other forms of income support; and

(2) one-time, short-term assistance (i.e., assistance paid within a 30-day period, no more than once in any twelve-month period, to meet needs that do not extend beyond a 90-day period, such as automobile repair to retain employment and avoid welfare receipt and appliance repair to maintain living arrangements).

Instruction: For each type of assistance provided under the State's MOE Program, enter the dollar amount of assistance that the State MOE family received or that was paid on behalf of the State MOE family for the reporting month and the number of months that the State MOE family has received assistance under the State's Separate MOE programs. If, for a "type of assistance", no dollar amount of assistance was provided during the reporting month, enter "0" as the amount. If, for a "type of assistance", no assistance has ever been received by the TANF eligible family, enter "0" as the number of months of assistance.

20. Cash and Cash Equivalents:

A. Amount B. Number of Months

21. Educational:

A. Amount B. Number of Months

22. Employment Services:

A. Amount B. Number of Months

23. Work Subsidies:

A. Amount B. Number of Months

24. Child Care:

Guidance: Include only the child care funded directly by the Separate State Programs. Do not include child care funded under the TANF Program or the Child Care and Development Fund, even though some of the funds were transferred to the CCDF from the State TANF program.

A. Amount B. Number of Months

25. Transportation:

A. Amount B. Number of Months

26. Other Supportive Services and Special Needs, including Assistance with Meeting Home Heating and Air Conditioning Costs:

A. Amount B. Number of Months

27. Transitional Services:

A. Amount B. Number of Months

28. Contributions to Individual Development Accounts:

A. Amount B. Number of Months

29. Other:

A. Amount B. Number of Months

Reason for and Amount of Reduction in Assistance

For each reason for which the State MOE family received a reduction in assistance for the reporting month, enter the dollar amount of the reduction in assistance. Otherwise, enter "0."

30. Work Requirements Sanction

31. Family Sanction for an Adult with No High School Diploma or Equivalent

32. Sanction for Teen Parent not Attending School

33. Non-Cooperation with Child Support

34. Failure to Comply with an Individual Responsibility Plan

35. Other Sanction

36. Recoupment of Prior Overpayment

37. Family Cap

38. Reduction Based on Family Moving into State From Another State

39. Reduction Based on Length of Receipt of Assistance

40. Other, Non-Sanction

41. Waiver Evaluation Research Group

Instruction: Enter the one-digit code that indicates the family's waiver evaluation case status.

Blank = Not applicable (no waivers apply to this case)

1 = Control group (for impact analysis purposes)

2 = Experimental group

3 = Non-experimental treatment group

Person-Level Data

Adult and Minor Child Head-of-household Characteristics

This section allows for coding up to six adults (or a minor child who is either a head-of-household or married to the head-of-household and up to five adults) in the State MOE family. A minor child who is either a head-of-household or married to the head-of-household should be coded as an adult and will hereafter be referred to as a "minor child head-of-household." For each adult (or minor child head-of-household) in the State MOE family, complete the adult characteristics section.

If there are more than six adults (or a minor child head-of-household and five adults) in the State MOE family, use the following order to identify the persons to be coded: (1) the head-of-household; (2) parents in the eligible family receiving assistance; (3) other adults in the eligible family receiving assistance; (4) Parents not in the eligible family receiving assistance; (5) caretaker relatives not in the eligible family receiving assistance; and (6) other persons, whose income or resources count in determining eligibility for or amount of assistance of the eligible family receiving assistance, in descending order the person with the most income to the person with least income.

42. Family Affiliation:

Instruction: Enter the one-digit code that shows the adult's (or minor child head-of-household's) relation to the eligible family receiving assistance.

1 = Member of the eligible family receiving assistance

Not in eligible family receiving assistance, but in the household

2 = Parent of minor child in the eligible family receiving assistance

3 = Caretaker relative of minor child in the eligible family receiving assistance

4 = Minor sibling of child in the eligible family receiving assistance

5 = Person whose income or resources are considered in determining eligibility for or amount of assistance for the eligible family receiving assistance

43. Noncustodial Parent Indicator:

Guidance: A noncustodial parent means a parent who does not live with his/her child(ren). A noncustodial parent who lives in the State, may participate in work activities funded under the Separate State Programs. If the noncustodial parent participates in work activities, (s)he must be a member of the eligible family receiving assistance and be reported as part of the State MOE family.

Instruction: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) noncustodial parent status.

1 = Yes, a noncustodial parent

2 = No, not a noncustodial parent

44. Date of Birth: Enter the eight-digit code for date of birth for the adult (or minor child head-of-household) under the Separate State Program in the format YYYYMMDD.

45. Social Security Number: Enter the nine-digit Social Security Number for the adult (or minor child head-of-household) in the format nnnnnnnnn.

46. Race: Enter the one-digit code for the race of the adult (or minor child head-of-household).

1 = White, not of Hispanic origin

2 = Black, not of Hispanic origin

3 = Hispanic

4 = American Indian or Alaska Native

5 = Asian or Pacific Islander

6 = Other

9 = Unknown

47. Gender: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) gender.

1 = Male

2 = Female

Receives Disability Benefits

48. Receives Federal Disability Insurance Benefits: Enter the one-digit code that indicates the adult (or minor child head-of-household) received Federal disability insurance benefits for the reporting month.

1 = Yes, received Federal disability insurance

2 = No

49. Receives Benefits Based on Federal Disability Status: Enter the one-digit code that indicates the adult (or minor child head-of-household) received benefits based on Federal disability status for the reporting month.

1 = Yes, received benefits based on Federal disability status

2 = No

50. Receives Aid Under Title XIV-APDT: Enter the one-digit code that indicates the adult (or minor child head-of-household) received aid under a State plan approved under Title XIV for the reporting month.

1 = Yes, received aid under Title XIV-APDT

2 = No

51. Receives Aid Under Title XVI-AABD: Enter the one-digit code that indicates the adult (or minor child head-of-household) received aid under a State plan approved under Title XVI-AABD for the reporting month.

1 = Yes, received aid under Title XVI-AABD

2 = No

52. Receives Aid Under Title XVI-SSI: Enter the one-digit code that indicates the adult (or minor child head-of-household) received aid under a State plan approved under Title XVI-SSI for the reporting month.

1 = Yes, received aid under Title XVI-SSI

2 = No

53. Marital Status: Enter the one-digit code for the adult's (or minor child head-of-household's) marital status for the reporting month.

1 = Single, never married

2 = Married, living together

3 = Married, but separated

4 = Widowed

5 = Divorced

54. Relationship to Head-of-Household:

Instruction: Enter the two-digit code that shows the adult's (or minor child head-of-household's) relationship (including by marriage) to the head of the household, as defined by the Food Stamp Program or as determined by the State, (i.e., the relationship to the principal person of each person living in the household.) If a minor child head-of-household, enter code "01."

01 = Head of household

02 = Spouse

03 = Parent

04 = Daughter or son (Natural or adoptive)

05 = Stepdaughter or stepson

06 = Grandchild or great grandchild

07 = Other related person (brother, niece, cousin)

08 = Foster child

09 = Unrelated child

10 = Unrelated adult

55. Teen Parent With Child In the Family:

Guidance: A teen parent is a person who is under 20 years of age and that person's child is also a member of the State MOE family.

Instruction: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) teen parent status.

1 = Yes, a teen parent

2 = No

Educational Level

Educational level is divided into two parts; the highest level of education attained and the highest degree attained.

56. Highest Level of Education Attained: Enter the two-digit code to indicate the highest level of education attained by the adult (or minor child head-of-household).

00 = No formal education

01-12 = Grade level completed in primary/secondary school including secondary level vocational school or adult high school

57. Highest Degree Attained: If the adult (or minor child head-of-household) has a degree(s), enter the one-digit code that indicates the highest degree attained. Otherwise, leave the field blank.

0 = No degree

1 = High school diploma, GED, or National External Diploma Program

2 = Awarded Associate's Degree

3 = Awarded Bachelor's Degree

4 = Awarded graduate degree (Master's or higher)

5 = Other credentials (degree, certificate,diploma, etc.)

58. Citizenship/Alienage:

Instruction: Enter the two-digit code that indicates the adult's (or minor child head-of-household's) citizenship/alienage.

01 = U.S. citizen, including naturalized citizens

03 = Qualified alien accorded refugee, Cuban or Haitian entrant, or Amerasian immigrant status (INS Form I-94) who has resided in the U.S. five years or less

06 = Qualified alien accorded refugee, Cuban or Haitian entrant, or Amerasian immigrant status (INS Form I-94) who has resided in the U.S. more than five years

07 = Qualified alien granted political asylum or granted withholding of deportation by INS (under sec. 243(h) or sec. 241(b)(3) of the INA) more than five years ago;

09 = Any alien who is not a qualified alien.

99 = Unknown

59. Employment Status: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) employment status.

1 = Employed

2 = Unemployed, looking for work

3 = Not in labor force (i.e, unemployed, not looking for work, includes discouraged workers)

60. Work Participation Status:

Guidance:

Disregarded from the participation rate means the State MOE family is not included in the calculation of the work participation rate.

Exempt means that the individual will not be penalized for failure to engage in work (i.e., good cause exception); however, the State MOE family is included in the calculation of the work participation rate.

Instruction: Enter the two-digit code that indicates the adult's (or minor child head-of-household's) work participation status.

01 = Disregarded from participation rate, single custodial parent with child under 12 months

03 = Disregarded, family is part of an ongoing research evaluation (as a member of a control group or experimental treatment group) approved under section 1115 of the Social Security Act

04 = Disregarded from participation rate, is participating in a Tribal Work Program, and State has opted to exclude all Tribal Work Program participants from its Work Participation rate

05 = Exempt, single custodial parent with child under age 6 and unavailability of child care

06 = Exempt, disabled (not using an extended definition under a State waiver)

07 = Exempt, caring for a severely disabled child (not using an extended definition under a State waiver)

08 = A temporary good cause domestic violence waiver (not using an extended definition under a State waiver)

09 = Exempt, State waiver

10 = Exempt, other

11 = Required to participate, but not participating, sanctioned for the reporting month and sanctioned for more than 3 months within the preceding 12-month period.

12 = Required to participate, but not participating, sanctioned for the reporting month but not sanctioned for more than 3 months within the preceding 12-month period

13 = Required to participate, but not participating and not sanctioned for the reporting month

14 = Deemed engaged in work, single teen head-of-household or married teen who maintains satisfactory school attendance or is participating in education directly related to employment for an average of at least 20 hours per week during the reporting month

15 = Deemed engaged in work, parent or relative (who is the only parent or caretaker relative in the family) with child under age 6 and parent engaged in work activities for at least 20 hours per week

16 = Required to participate, participating but not meeting minimum participation requirements

17 = Required to participate, and meeting minimum participation requirements

99 = Not applicable (e.g., person in household, but not in eligible family receiving assistance)

Adult Work Participation Activities:

Some weeks have days in more than one month. Include such a week in the calculation for the month that contains the most days of the week (e.g., the week of July 27 - August 2, 1997 would be included in the July calculation). Acceptable alternatives to this approach must account for all weeks in the fiscal year. One acceptable alternative is to include the week in the calculation for the month in which the Friday falls (i.e., the JOBS approach). A second acceptable alternative is to count each month as having 4.33 weeks.

Instruction: For each work activity in which the adult (or minor child head-of-household) participated during the reporting month, enter the average number of hours per week of participation. For each work activity in which the adult (or minor child head-of-household) did not participate, enter zero as the average number of hours per week of participation.

61. Unsubsidized Employment

62. Subsidized Private Sector Employment

63. Subsidized Public Sector Employment

64. Work Experience

65. Onthejob Training

66. Job Search and Job Readiness Assistance

67. Community Service Programs

68. Vocational Educational Training

69. Job Skills Training Directly Related to Employment

70. Education Directly Related to Employment for Individuals with no High School Diploma or Certificate of High School Equivalency

71. Satisfactory School Attendance for Individuals with No High School Diploma or Certificate of High School Equivalency

72. Providing Child Care Services to an Individual who is Participating in a Community Service Program

73. Additional Work Activities Permitted Under Waiver Demonstration

Instruction: Hours of participation in job search and job readiness training beyond the TANF limits as permitted by State waiver should be counted in this item. Otherwise, count such additional hours of work participation under the work activity "Other Work Activities."

74. Other Work Activities

75. Required Hours of Work Under Waiver Demonstration:

Guidance: In approving waivers, ACF specified hours of participation in several instances. One type of hour change in the welfare reform demonstrations, was the recognition, as part of a change in work activities and/or exemptions, that the hours individuals worked should be consistent with their abilities and in compliance with an employability or personal responsibility plan or other criteria in accordance to waiver terms and conditions. As the hour requirement in this case was integral and necessary to achieve the waiver purpose of appropriately requiring work activities to move individuals to self-sufficiency, the State could show inconsistency and could use the waiver hours instead of the hours in section 407. The waiver that increase work hour requirements would not be deemed inconsistent.

Amount of Earned Income

Earned income has two categories. For each category of earned income, enter the dollar amount of the adult's (or minor child head-of-household's) earned income.

76. Earned Income Tax Credit (EITC):

77. Wages, Salaries, and Other Earnings:

Amount of Unearned Income

Unearned income has four categories. For each category of unearned income, enter the dollar amount of the adult's (minor child head-of-household's) unearned income.

78. Social Security: Enter the dollar amount of Social Security that the adult in the State MOE family has received for the reporting month.

79. SSI: Enter the dollar amount of SSI that the adult in the State MOE family has received for the reporting month.

80. Worker's Compensation: Enter the dollar amount of Worker's Compensation that the adult in the State MOE family has received for the reporting month.

81. Other Unearned Income:

Guidance: Other unearned income includes RSDI benefits, Veterans benefits, Unemployment Compensation, other government benefits, housing subsidy, contribution/income-in-kind, deemed income, Public Assistance or General Assistance, educational grants/scholarships/loans, other. Do not include Social Security, SSI, Worker's Compensation, value of Food Stamps assistance, the amount of the Child Care subsidy, and the amount of Child Support.

Instruction: Enter the dollar amount of other unearned income that the adult in the State MOE family has received for the reporting month.

Child Characteristics

This section allows for coding up to ten children in the State MOE family. A minor child head-of-household should be coded as an adult, not as a child. The youngest child should be coded as the first child in the family, the second youngest child as the second child, and so on. If the needs of an unborn child are included in the amount of assistance provided to the family, code the unborn child as one of the children. Do this by entering the Date-of-Birth as "99999999" and leave the other Child Characteristics fields blank.

If there are more than ten children in the State MOE family, use the following order to identify the persons to be coded: (1) children in the eligible family receiving assistance in order from youngest to oldest; (2) minor siblings of child in the eligible family receiving assistance from youngest to oldest; and (3) any other children.

82. Family Affiliation:

Instruction: Enter the one-digit code that shows the Child's relation to the eligible family receiving assistance.

1 = Member of the eligible family receiving assistance

Not in eligible family receiving assistance, but in the household

2 = Parent of minor child in the eligible family receiving assistance

3 = Caretaker relative of minor child in the eligible family receiving assistance

4 = Minor sibling of child in the eligible family receiving assistance

5 = Person whose income is considered in determining eligibility for and amount of assistance for the eligible family receiving assistance

83. Date of Birth: Enter the eight-digit code for date of birth for this child under the Separate State Programs in the format YYYYMMDD.

84. Social Security Number: Enter the nine-digit Social Security Number for the child in the format nnnnnnnnn.

85. Race: Enter the one-digit code for the race of the State MOE child.

1 = White, not of Hispanic origin

2 = Black, not of Hispanic origin

3 = Hispanic

4 = American Indian or Alaska Native

5 = Asian or Pacific Islander

6 = Other

9 = Unknown

86. Gender: Enter the one-digit code that indicates the child's gender.

1 = Male

2 = Female

Receives Disability Benefits

87. Receives Benefits Based on Federal Disability Status: Enter the one-digit code that indicates the child received benefits based on Federal disability status for the reporting month.

1 = Yes, received benefits based on Federal disability status

2 = No

88. Receives Aid Under Title XVI-SSI: Enter the one-digit code that indicates the child received aid under a State plan approved under Title XVI-SSI for the reporting month.

1 = Yes, received aid under Title XVI-SSI

2 = No

89. Relationship to Head-of-Household:

Instruction: Enter the two-digit code that shows the child's relationship (including by marriage) to the head of the household, as defined by the Food Stamp Program or, principal person of each person living in the household.

01 = Head of household

02 = Spouse

03 = Parent

04 = Daughter or son (Natural or adoptive)

05 = Stepdaughter or stepson

06 = Grandchild or great grandchild

07 = Other related person (brother, niece, cousin)

08 = Foster child

09 = Unrelated child

10 = Unrelated adult

90. Teen Parent With Child In the Family:

Guidance: A teen parent is a person who is under 20 years of age and that person's child is also a member of the State MOE family.

Instruction: Enter the one-digit code that indicates the child's teen parent status.

1 = Yes, a teen parent

2 = No

Educational Level

Educational level is divided into two parts; the highest level of education attained and the highest degree attained.

91. Highest Level of Education Attained: Enter the two-digit code to indicate the highest level of education attained by the child.

00 = No formal education

01-12 = Grade level completed in primary/secondary school including secondary level vocational school or adult high school

92. Highest Degree Attained:

Instruction: If the child has a degree(s), enter the one-digit code that indicates the child's highest degree attained. Otherwise, leave the field blank.

0 = No degree

1 = High school diploma, GED, or National External Diploma Program

2 = Awarded Associate's Degree

3 = Awarded Bachelor's Degree

4 = Awarded graduate degree (Master's or higher)

5 = Other credentials (degree, certificate, diploma, etc.)

9 = Not applicable

93. Citizenship/Alienage: Enter the two-digit code that indicates the child's citizenship/alienage. The coding for this data element is the same as for item number 0, on page 504.

94. Cooperation with Child Support: Enter the one-digit code that indicates whether this child's parent has cooperated with child support for this child.

1 = Yes, parent cooperates with child support

2 = No

3 = Not applicable

Amount of Unearned Income

Unearned income has two categories. For each category of unearned income, enter the dollar amount of the child's unearned income.

95. SSI: Enter the dollar amount of SSI that the child in the State MOE family has received for the reporting month.

96. Other Unearned Income: Enter the dollar amount of other unearned income that the child in the State MOE family has received for the reporting month.

APPENDIX F

TANF MOE Data Report - Section Two

Disaggregated Data Collection

for Families No Longer Receiving Assistance

under the Separate State Programs

Instructions and Definitions

General Instruction: The State agency should collect and report data for each data element shown below.

1. State FIPS Code: Enter your two-digit State code from the following listing. These codes are the standard codes used by the National Institute of Standards and Technology.

2. County FIPS Code: Enter the three-digit code established by the National Institute of Standards and Technology for classification of counties and county equivalents. Codes were devised by listing counties alphabetically and assigning sequentially odd integers; e.g., 001, 003, 005, . . . . A complete list of codes is available in Appendix F of the TANF Sampling and Statistical Methods Manual.

3. Reporting Month: Enter the four-digit year and two-digit month code that identifies the year and month for which the data are being reported.

4. Stratum:

Instruction: Enter the two-digit stratum code.

Family-Level Data

(1) Parent(s) or caretaker relative(s) of any minor child receiving assistance;

(2) Minor siblings (including unborn children) of any child receiving assistance; and

(3) Any person whose income or resources would be counted in determining the family's eligibility for or amount of assistance.

5. Case Number:

Guidance: If the case number is less than the allowable eleven characters, a State may use lead zeros to fill in the number.

Instruction: Enter the number that was assigned by the State agency to uniquely identify the State MOE family.

6. ZIP Code: Enter the five-digit ZIP code for the family's place of residence for the reporting month.

7. Disposition: Enter one of the following codes for each State MOE family.

1 = Data collection completed

2 = Not subject to data collection/listed in error

8. Reason for Closure:

Guidance: A closed case is a family whose assistance was terminated for the reporting month, but received assistance under the State's MOE Program in the prior month. A temporally suspended case is not a closed case. If there is more than one applicable reason for closure, determine the principal (i.e., most relevant) reason. If two or more reasons are equally relevant, use the reason with the lowest numeric code.

Instruction: Enter the one-digit code that indicates the reason for the State MOE family no longer receiving assistance.

1 = Employment

2 = Marriage

3 = Five-Year Time Limit

4 = Sanction

5 = State policy

6 = Minor child absent from the home for a significant time period

7 = Transfer to State TANF Program

8 = Other

9. Number of Family Members: Enter two digits that represent the number of members in the State MOE family, which received assistance under the Separate State Programs.

10. Receives Subsidized Housing:

Instruction: Enter the one-digit code that indicates whether or not the State MOE family received subsidized housing for the sample month.

1 = Public housing

2 = HUD rent subsidy

3 = Other rent subsidy

4 = No housing subsidy

11. Receives Medical Assistance: Enter "1" if, for the sample month, any State MOE family member is eligible to receive (i.e., a certified recipient of) medical assistance under the State plan approved under Title XIX or "2" if no State MOE family member is eligible to receive medical assistance under the State plan approved under Title XIX.

1 = Yes, receives medical assistance

2 = No

12. Receives Food Stamps: If the State MOE family received Food Stamps for the sample month, enter the one-digit code indicating the type of Food Stamp assistance. Otherwise, enter "4."

1 = Yes, Food Stamp coupon allotment

2 = Yes, cash

3 = Yes, wage subsidy

4 = No

13. Amount of Food Stamp Assistance:

Guidance: For situations in which the Food Stamp household differs from the TANF family, code this element in a manner that most accurately reflects the resources available to the TANF family.

Instruction: Enter the State MOE family's authorized dollar amount of Food Stamp assistance for the reporting month. If the State MOE family did not receive any food stamps for the reporting month, enter "0."

14. Receives Subsidized Child Care:

Instruction: If the State MOE family receives subsidized child care for the reporting month, enter code "1", "2", "3", or "4", whichever is appropriate. Otherwise, enter code "5."

1 = Yes, funded under the Separate State Programs

2 = Yes, funded under the Child Care and Development Fund

3 = Yes, funded under other Federal program (e.g., TANF or SSBG)

4 = Yes, funded under other State or local program

5 = No

15. Amount of Subsidized Child Care:

Instruction: Enter the dollar amount of subsidized child care that the State MOE family has received for services in the reporting month. If the State MOE family did not receive any subsidized child care for the reporting month, enter "0."

Person-Level Data

Adult and Minor Child Head-of-household Characteristics

This section allows for coding up to six adults (or a minor child head-of-household and up to five adults) in the State MOE family. A minor child head-of-household should be coded as an adult. For each adult (or minor child head-of-household) in the State MOE family, complete the adult characteristics section.

16. Family Affiliation:

Instruction: Enter the one-digit code that shows the adult's (minor child head-of-household's) relation to the eligible family receiving assistance.

1 = Member of the eligible family receiving assistance

Not in eligible family receiving assistance, but in the household

2 = Parent of minor child in the eligible family receiving assistance

3 = Caretaker relative of minor child in the eligible family receiving assistance

4 = Minor sibling of child in the eligible family receiving assistance

5 = Person whose income or resources are considered in determining eligibility for or amount of assistance for the eligible family receiving assistance

17. Date of Birth: Enter the eight-digit code for date of birth for this adult (or minor child head-of-household) under Separate State Programs in the format YYYYMMDD.

18. Social Security Number: Enter the nine-digit Social Security Number for the adult (or minor child head-of-household) in the format nnnnnnnnn.

19. Race: Enter the one-digit code for the race of the State MOE adult (or minor child head-of-household).

1 = White, not of Hispanic origin

2 = Black, not of Hispanic origin

3 = Hispanic

4 = American Indian or Alaska Native

5 = Asian or Pacific Islander

6 = Other

9 = Unknown

20. Gender: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) gender.

1 = Male

2 = Female

Receives Disability Benefits

21. Receives Federal Disability Insurance Benefits: Enter the one-digit code that indicates the adult (or minor child head-of-household) received Federal disability insurance benefits for the reporting month.

1 = Yes, received Federal disability insurance

2 = No

22. Receives Benefits Based on Federal Disability Status: Enter the one-digit code that indicates the adult (or minor child head-of-household) received benefits based on Federal disability status for the reporting month.

1 = Yes, received benefits based on Federal disability status

2 = No

23. Receives Aid Under Title XIV-APDT: Enter the one-digit code that indicates the adult (or minor child head-of-household) received aid under a State plan approved under Title XIV for the reporting month.

1 = Yes, received aid under Title XIV-APDT

2 = No

24. Receives Aid Under Title XVI-AABD: Enter the one-digit code that indicates the adult (or minor child head-of-household) received aid under a State plan approved under Title XVI-AABD for the reporting month.

1 = Yes, received aid under Title XVI-AABD

2 = No

25. Receives Aid Under Title XVI-SSI: Enter the one-digit code that indicates the adult (or minor child head-of-household) received aid under a State plan approved under Title XVI-SSI for the reporting month.

1 = Yes, received aid under Title XVI-SSI

2 = No

26. Marital Status: Enter the one-digit code for the marital status of the adult (or minor child head-of-household).

1 = Single, never married

2 = Married, living together

3 = Married, but separated

4 = Widowed

5 = Divorced

27. Relationship to Head-of-Household:

Instruction: Enter the two-digit code that shows the adult's (or minor child head-of-household's) relationship (including by marriage) to the head of the household, as defined by the Food Stamp Program or, principal person of each person living in the household. If a minor child head-of-household, enter code "01."

01 = Head of household

02 = Spouse

03 = Parent

04 = Daughter or son

05 = Stepdaughter or stepson

06 = Grandchild or great grandchild

07 = Other related person (brother, niece, cousin)

08 = Foster child

09 = Unrelated child

10 = Unrelated adult

28. Teen Parent With Child In the Family:

Guidance: A teen parent is a person who is under 20 years of age and that person's child is also a member of the State MOE family.

Instruction: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) teen parent status.

1 = Yes, a teen parent

2 = No

Educational Level

Educational level is divided into two parts: the highest level of education attained and the highest degree attained.

29. Highest Level of Education Attained: Enter the two-digit code to indicate the highest level of education attained by the adult (or minor child head-of-household).

00 = No formal education

01-12 = Grade level completed in primary/secondary school including secondary level vocational school or adult high school

30. Highest Degree Attained: If the adult (or minor child head-of-household) has a degree(s), enter the one-digit code that indicates the adult's (or minor child head-of-household's) highest degree attained. Otherwise, leave the field blank.

0 = No degree

1 = High school diploma, GED, or National External Diploma Program

2 = Awarded Associate's Degree

3 = Awarded Bachelor's Degree

4 = Awarded graduate degree (Master's or higher)

5 = Other credentials (degree, certificate, diploma, etc.)

31. Citizenship/Alienage:

Instruction: Enter the two-digit code that indicates the adult's (or minor child head-of-household's) citizenship/alienage.

01 = U.S. citizen, including naturalized citizens

03 = Qualified alien accorded refugee, Cuban or Haitian entrant, or Amerasian immigrant status (INS Form I-94) who has resided in the U.S. five years or less

06 = Qualified alien accorded refugee, Cuban or Haitian entrant, or Amerasian immigrant status (INS Form I-94) who has resided in the U.S. more than five years

07 = Qualified alien granted political asylum or granted withholding of deportation by INS (under sec. 243(h) or sec. 241(b)(3) of the INA) more than five years ago;

09 = Any alien who is not a qualified alien.

99 = Unknown

32. Employment Status: Enter the one-digit code that indicates the adult's (or minor child head-of-household's) employment status.

1 = Employed

2 = Unemployed, looking for work

3 = Not in labor force (i.e, unemployed, not looking for work, includes discouraged workers))

Amount of Earned Income

For each category of earned income, enter the dollar amount of the adult's (or minor child head-of-household's) earned income.

33. Earned Income Tax Credit (EITC):

34. Wages, Salaries, and Other Earnings:

Amount of Unearned Income

35. Unearned Income: Enter the dollar amount of the adult's (or minor child head-of-household's) unearned income.

Child Characteristics

36. Family Affiliation:

Instruction: Enter the one-digit code that shows the Child's relation to the eligible family receiving assistance.

1 = Member of the eligible family receiving assistance

Not in eligible family receiving assistance, but in the household

2 = Parent of minor child in the eligible family receiving assistance

3 = Caretaker relative of minor child in the eligible family receiving assistance

4 = Minor sibling of child in the eligible family receiving assistance

5 = Person whose income is considered in determining eligibility for and amount of assistance for the eligible family receiving assistance

37. Date of Birth: Enter the eight-digit code for date of birth for this child under the Separate State Programs in the format YYYYMMDD.

38. Social Security Number: Enter the nine-digit Social Security Number for the child in the format nnnnnnnnn.

39. Race: Enter the one-digit code for the race of the State MOE child.

1 = White, not of Hispanic origin

2 = Black, not of Hispanic origin

3 = Hispanic

4 = American Indian or Alaska Native

5 = Asian or Pacific Islander

6 = Other

9 = Unknown

40. Gender: Enter the one-digit code that indicates the child's gender.

1 = Male

2 = Female

Receives Disability Benefits

41. Receives Benefits Based on Federal Disability Status: Enter the one-digit code that indicates the child received benefits based on Federal disability status for the reporting month.

1 = Yes, received benefits based on Federal disability status

2 = No

42. Receives Aid Under Title XVI-SSI: Enter the one-digit code that indicates the child received aid under a State plan approved under Title XVI-SSI for the reporting month.

1 = Yes, received aid under Title XVI-SSI

2 = No

43. Relationship to Head-of-Household:

Instruction: Enter the two-digit code that shows the relationship (including by marriage) to the head of the household, as defined by the Food Stamp Program or, principal person of each person living in the household.

01 = Head of household

02 = Spouse

03 = Parent

04 = Daughter or son

05 = Stepdaughter or stepson

06 = Grandchild or great grandchild

07 = Other related person (brother, niece, cousin)

08 = Foster child

09 = Unrelated child

10 = Unrelated adult

44. Teen Parent With Child In the Family:

Guidance: A teen parent is a person who is under 20 years of age and that person's child is also a member of the State MOE family.

Instruction: Enter the one-digit code that indicates the child's teen parent status.

1 = Yes, a teen parent

2 = No

Educational Level

Educational level is divided into two parts; the highest level of education attained and the highest degree attained.

45. Highest Level of Education Attained: Enter the two-digit code to indicate the highest level of education attained by the child.

00 = No formal education

01-12 = Grade level completed in primary/secondary school including secondary level vocational school or adult high school

46. Highest Degree Attained:

Instruction: If the child has a degree(s), enter the one-digit code that indicates the child's highest degree attained. Otherwise, leave the field blank.

0 = No degree

1 = High school diploma, GED, or National External Diploma Program

2 = Awarded Associate's Degree

3 = Awarded Bachelor's Degree

4 = Awarded graduate degree (Master's or higher)

5 = Other credentials (degree, certificate, diploma, etc.)

47. Citizenship/Alienage: Enter the two-digit code that indicates the child's citizenship/alienage. The coding for this data element is the same as for item number 0, on page 504.

48. Cooperation with Child Support: Enter the one-digit code that indicates this child's parent has cooperated with child support for this child.

1 = Yes, child's parent has cooperated with child support

2 = No, child's parent has not cooperated with child support

3 = Not applicable

49. Unearned Income: Enter the dollar amount of the child 's unearned income.

APPENDIX G

TANF MOE Data Report - Section Three

Aggregated Data Collection

for Families Receiving Assistance

under the Separate State Programs

Instructions and Definitions

1. State FIPS Code: Enter your two-digit State code.

2. Calendar Quarter: The four calendar quarters are as follows:

First quarter .....January - March

Second quarter.... April - June

Third quarter......July - September

Fourth quarter.....October - December

ACTIVE CASES

For purposes of completing this report, include all TANF eligible families receiving assistance under the Separate State programs, i.e., State MOE families. All counts of families and recipients should be unduplicated monthly totals.

3. Total Number of Families: Enter the number of families receiving assistance under the Separate State Programs for each month of the quarter. The total in this item should equal the sum of the number of two-parent families (in item #4), the number of one-parent families (in item #5) and the number of no-parent families (in item #6).

A. First Month: B. Second Month: C. Third Month:

4. Total Number of Two-parent Families: Enter the total number of two-parent families receiving assistance under the Separate State Programs for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

5. Total Number of One-Parent Families: Enter the total number of one-parent families receiving assistance under the Separate State Programs for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

6. Total Number of No-Parent Families: Enter the total number of no-parent families receiving assistance under the Separate State Programs for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

7. Total Number of Recipients: Enter the total number of recipients receiving assistance under the Separate State Programs for each month of the quarter. The total in this item should equal the sum of the number of adult recipients (in item #8) and the number of child recipients (in item #9).

A. First Month: B. Second Month: C. Third Month:

8. Total Number of Adult Recipients: Enter the total number of adult recipients receiving assistance under the Separate State Programs for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

9. Total Number of Child Recipients: Enter the total number of child recipients receiving assistance under the Separate State Programs for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

10. Total Number of Non-Custodial Parents Participating in Work Activities: Enter the total number of non-custodial parents participating in work activities under the Separate State Programs for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

11. Total Number of Minor Child Heads-of-Household: Enter the total number of minor child head-of-household families receiving assistance under the Separate State Programs for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

12. Total Number of Births: Enter the total number of births for families receiving assistance under the Separate State Programs for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

13. Total Number of Out-of-Wedlock Births: Enter the total number of out-of-wedlock births for families receiving assistance under the Separate State Programs for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

14. Total Amount of Assistance: Enter the dollar value of all assistance (cash and non-cash) provided to families under the Separate State Programs for each month of the quarter. Round the amount of assistance to the nearest dollar.

A. First Month: B. Second Month: C. Third Month:

CLOSED CASES

15. Total Number of Closed Cases: Enter the total number of closed cases for each month of the quarter.

A. First Month: B. Second Month: C. Third Month:

APPENDIX H

Sampling Specifications

1. Sample Methodology

The sample methodology must conform to principles of probability sampling, i.e., each family in the population of interest must have a known, nonzero probability of selection and computational methods of estimation must lead to a unique estimate. The State must construct a sample frame for each month in the annual sample period and must select approximately one-twelfth of the required minimum annual sample size from each monthly sample frame.

The recommended method of sample selection is stratified systematic random sampling.

2. Sample frame requirements for

a. families receiving assistance under the state TANF Program (i.e., the active TANF sample) are:

The monthly TANF sample frame must consist of an unduplicated list of all families who receive assistance under the State TANF Program for the reporting month by the end of the reporting month. Only families with a minor child who resides with a custodial parent or other adult relative or a pregnant woman may receive assistance.

b. families no longer receiving assistance under the State TANF Program (i.e., the closed TANF sample) are:

For closed cases, the monthly TANF sample frame must consist of an unduplicated list of all families who assistance under the State TANF Program was terminated for the reporting month (do not include families whose assistance was temporarily suspended), but received assistance under the State's TANF Program in the prior month. Thus, TANF eligible families that are transferred to a Separate State Program are closed cases for the State TANF Program.

c. families receiving assistance under the Separate State Programs (i.e., the active Separate State sample) are:

The monthly Separate State sample frame must consist of an unduplicated list of all TANF-eligible families who receive assistance under the Separate State Programs for the reporting month by the end of the reporting month.

d. families no longer receiving assistance under the Separate State Programs (i.e., the closed Separate State sample) are:

For closed cases, the monthly Separate State sample frame must consist of an unduplicated list of all families who assistance under the Separate State Programs was terminated for the reporting month (do not include families whose assistance was temporarily suspended), but received assistance under the Separate State Programs in the prior month. Thus, State MOE families that are transferred to a State TANF Program are closed cases for the Separate State Programs.

3. Sample Size Requirement

a. for families receiving assistance under a State TANF Program are:

The minimum required annual sample size for families receiving assistance is 3000 families, of which 600 families must be newly, approved applicants. Of the 2400 families that have received ongoing assistance approximately 25% (600 families) must be two-parent TANF families. We established the minimum required sample sizes to provide reasonably precise estimates (e.g., a precision of about plus or minus 2 percentage points at a 95% confidence level) for such proportions as the work participation rates for all families and for two-parent families, as well as for demographic and case characteristics of newly, approved TANF families and all TANF families.

b. for families no longer receiving assistance under a State TANF Program are:

The minimum required annual sample size for the sample of families no longer receiving assistance (i.e., closed cases) is 800 families.

c. for families receiving assistance under a Separate State Programs are:

The minimum required annual sample size for families receiving assistance under the Separate State Programs is 3000 families, of which 600 families must be newly, approved applicants. Of the 2400 families that have received ongoing assistance approximately 25% (600 families) must be two-parent TANF-eligible families. We established the minimum required sample sizes to provide reasonably precise estimates (e.g., a precision of about plus or minus 2 percentage points at a 95% confidence level) for such proportions as the work participation rates for all families and for two-parent families, as well as for demographic and case characteristics of State MOE families.

d. for families no longer receiving assistance under a Separate State Programs are:

The minimum required annual sample size for the sample of families no longer receiving assistance (i.e., closed cases) under the Separate State Programs is 800 families.

4. What must States submit to ACF?

Each State that opts to sample its caseloads must submit the following:

a. Each State must submit for approval its annual sampling plan or any changes to its currently approved sampling plan at least sixty (60) calendar days before the start of the annual period. If the State's sampling plan is unchanged from the previous year, the State is not required to resubmit the sampling plan. The sampling plan must satisfy the requirements for plan approval as specified in Section 1300 of the TANF Sampling and Statistical Methods Manual and includes the following:

i. Documentation of methods for constructing and maintaining the sample frame(s), including assessment of frame completeness and any potential problems associated with using the sample frame(s);

ii. Documentation of methods for selecting the sample cases from the sample frame(s); and

iii. Documentation of methods for estimating case characteristics and their sampling errors, including the computation of weights, where appropriate.

b. Each State must submit the estimated average monthly caseload for the annual sample period and the computed sample interval (if applicable) to the ACF Regional Administrator thirty (30) calendar days before the beginning of the annual sample period, i.e., by September 1 for the October sample selection. States must submit the monthly list of selected sample cases (including reserve pool cases, if applicable) within 10 days of the date of selection specified in the State sampling plan.

c. Each State must submit the total number of families receiving assistance under the State TANF Program by stratum for each month in the annual sample period, the total number of families no longer receiving assistance under the State TANF Program (if stratified, by stratum) for each month in the annual sample period, the total number of families receiving assistance under the Separate State Programs by stratum for each month in the annual sample period, and the total number of families no longer receiving assistance under the Separate State Programs (if stratified, by stratum) for each month in the annual sample period. This data is required for weighting the sample results in order to produce estimates for the entire caseload.

APPENDIX I

Statutory Reference Table for Appendix A

Data Elements Justification

1. State FIPS Code Implicit in administering data collection system

2. County FIPS Code 411 (a) (1) (A) (i)

3. Tribal Code Implicit in administering data collection system

4. Reporting Month Implicit in administering data collection system

5. Stratum Implicit in administering data collection system

Family Level Data Items 6 - 44

6. Case Number Implicit in administering data collection system

7. ZIP Code Needed for geographic coding (and rural/urban analyses) and is readily available.

8. Funding Stream 411 (a) (1) (A) (xii): Use in calculation of participation rate.

9. Disposition Implicit in administering data collection system

10. New Applicant 411 (b), requires the Secretary to report to Congress on families applying for TANF assistance. This element identifies applicants that are newly, approved families receiving assistance.

11. Number of Family Members 411 (a) (1) (A) (iv)

12. Type of Family for Work Participation 411 (a) (1) (A) (xii): Use in calculation of participation rate.

13. Receives Subsidized Housing 411 (a) (1) (A) (ix)

14. Receives Medical Assistance 411 (a) (1) (A) (ix)

15. Receives Food Stamps 411 (a) (1) (A) (ix)

16. Amount of Food Stamp Assistance 411 (a) (1) (A) (ix)

17. Receives Subsidized Child Care 411 (a) (1) (A) (ix)

18. Amount of Subsidized Child Care 411 (a) (1) (A) (ix)

19. Amount of Child Care Disregard The CCDF sample will not capture children whose child care is funded by TANF. The data element is collected here because it is required under CCDF and this is the most cost-effective way to capture TANF Child Care information. (See Sec. 658K (a)(2)(C)).

20. Amount of Child Support 411 (a) (1) (A) (xiv): break-out of unearned income.

21. Amount of the Families' Cash Resources 411 (b), requires the Secretary to report to Congress on financial circumstances of families receiving TANF assistance.

Amount of Assistance Received and Number of Months the Family Received Assistance by Type under the State TANF Program items 22 - 31 are types of assistance

22. Cash and Cash Equivalents 411 (a) (1) (A) (x) & (xiii)

23. Educational 411 (a) (1) (A) (x) & (xiii)

24. Employment Services 411 (a) (1) (A) (x) & (xiii)

25. Work Subsidies 411 (a) (1) (A) (x) & (xiii)

26. TANF Child Care 411 (a) (1) (A) (x) & (xiii)

27. Transportation 411 (a) (1) (A) (x) & (xiii)

28. Other Supportive Services and Special Needs, Including Assistance with Meeting Home Heating and Air Conditioning Costs 411 (a) (1) (A) (x) & (xiii)

29. Transitional Services 411 (a) (1) (A) (x) & (xiii)

30. Contributions to Individual Development Accounts 411 (a) (1) (A) (x) & (xiii)

31. Other 411 (a) (1) (A) (x) & (xiii)

Reason for and Amount of Reduction in Assistance Items 32 - 42 are the reasons for reduction in assistance

32. Work Requirements Sanction 411 (a) (1) (A) (xiii)

33. Family Sanction for an Adult with No High School Diploma or Equivalent 411 (a) (1) (A) (xiii)

34. Sanction for Teen Parent Not Attending School 411 (a) (1) (A) (xiii)

35. Non-Cooperation with Child Support 411 (a) (1) (A) (xiii)

36. Failure to Comply with an Individual Responsibility Plan 411 (a) (1) (A) (xiii)

37. Other Sanction 411 (a) (1) (A) (xiii)

38. Recoupment of Prior Overpayment 411 (a) (1) (A) (xiii)

39. Family Cap 411 (a) (1) (A) (xiii)

40. Reduction Based on Family Moving into State From Another State 411 (a) (1) (A) (xiii)

41. Reduction Based on Length of Receipt of Assistance 411 (a) (1) (A) (xiii)

42. Other, Non-sanction 411 (a) (1) (A) (xiii)

43. Waiver Evaluation Research Group 411 (a) (1) (A) (xii): Use to calculate the participation rate for States with an ongoing waiver evaluation for impact analysis purposes

44. Is the TANF Family Exempt from the Federal Time Limit 409 (a) (9)

Adult Characteristics items 45 - 88

45. Family Affiliation 411 (a) (1) (A) (iv) and 411 (b): Needed to identify persons in eligible family receiving assistance and other individuals living in the household.

46. Noncustodial Parent Indicator 411 (a) (4): Report on Non-custodial Parents requires the number of non-custodial Parents. To provide assistance to non-custodial parents under the State TANF Program, States must include them in the family. Data could be collected under the element Relationship to Head-of-Household. Element was broken out to make the coding cleaner and easier for States to report.

47. Date of Birth 411 (a) (1) (A) (iii): Age - Date of birth gives the same information but is a constant.

48. Social Security Number This information is also readily available. States use Social Security Numbers to carry out the requirements of IEVS (see sections 409(a)(4) and 1137 of the Act). We need this information also for research on the circumstances of children and families as required in section 413(g) of the Act (i.e., to track individual members of the TANF family).

49. Race 411 (a) (1) (A) (vii)

50. Gender Data could be collected under the element Relationship to Head-of-Household (e.g., husband, wife, daughter, son, etc.). Element was broken out to make the coding cleaner and easier for States to report. Used the Secretary's Report to the Congress.

Receives Federal Disability Benefits Items 51 - 55

51. Receives Federal Disability Insurance Benefits 411 (a) (1) (A) (ii) as revised by P.L. 105-33

52. Receives Benefits Based on Federal Disability Status 411 (a) (1) (A) (ii) as revised by P.L. 105-33

53. Receives Aid Under Title XIV-APDT 411 (a) (1) (A) (ii) as revised by P.L. 105-33

54. Receives Aid Under Title XVI-AABD 411 (a) (1) (A) (ii) as revised by P.L. 105-33

55. Receives Aid Under Title XVI-SSI 411 (a) (1) (A) (ii) as revised by P.L. 105-33

56. Marital Status 411 (a) (1) (A) (vi)

57. Relationship to Head-of-Household 411 (a) (1) (A) (iv) as revised by P.L. 105-33

58. Teen Parent with Child in the Family 411 (a) (1) (A) (xvii) as revised by P.L. 105-33

Adult Educational Level Items 59 and 60

59. Highest Level of Education Attained 411 (a) (1) (A) (vii)

60. Highest Degree Attained 411 (a) (1) (A) (vii)

61. Citizenship /Alienage 411 (a) (1) (A) (xv): We have updated our prior coding of citizenship status to reflect the complexity of TANF; also 409 (a) (1)

62. Number of Months Countable toward Federal Time Limit in Own State (Tribe) 409 (a) (9)

63. Number of Months Countable toward Federal Time Limit in Other States or Tribes 409 (a) (9)

64. Number of Countable Months Remaining Under State's Time Limit 409 (a) (9)

65. Is Current Month Exempt from the State's Time Limit 409 (a) (9)

66. Employment Status 411 (a) (1) (A) (v)

67. Work Participation Status 411 (a) (1) (A) (xii): Needed to calculate the work participation rate.

Adult Work Participation Activities Items 68 - 81 are the work participation activities and are needed to calculate the work participation rate.

68. Unsubsidized Employment 411 (a) (1) (A) (xi) (III)

69. Subsidized Private Sector Employment 411 (a) (1) (A) (xi) (II)

70. Subsidized Public Sector Employment 411 (a) (1) (A) (xi) (IV)

71. Work Experience 411 (a) (1) (A) (xi) (IV)

72. Onthejob Training 411 (a) (1) (A) (xi) (VI)

73. Job Search and Job Readiness Assistance 411 (a) (1) (A) (xi) (V)

74. Community Service Programs 411 (a) (1) (A) (xi) (IV)

75. Vocational Educational Training 411 (a) (1) (A) (xi) (VII)

76. Job Skills Training Directly Related to Employment 411 (a) (1) (A) (xi) (VI)

77. Education Directly Related to Employment for Individuals with no High School Diploma or Certificate of High School Equivalency 411 (a) (1) (A) (xi) (I)

78. Satisfactory School Attendance for Individuals with no High School Diploma or Certificate of High School Equivalency 411 (a) (1) (A) (xi) (I)

79. Providing Child Care Services to an Individual who is Participating in a Community Service Program 411 (a) (1) (A) (xi)

80. Additional Work Activities Permitted Under Waiver 411 (a) (1) (A) (xii): Use to calculate work participation rate, when approved 1115 waiver permits other work activities.

81. Other Work Activities Related to 411 (a) (1) (A) (xii) and 409 (a) (3)

82. Required Hours of Work Under Waiver 411 (a) (1) (A) (xii): Use to calculate the Work participation rate, when approved 1115 waiver permits a different number of hours of work participation to count as engaged in work

Adult Earned Income Items 83 and 84 break out earned income.

83. Earned Income Tax Credit (EITC) 411 (a) (1) (A) (v)

84. Wages, Salaries, and Other Earnings 411 (a) (1) (A) (v)

Adult Unearned Income Items 85 and 88 break out Unearned income.

85. Amount of Social Security 411 (a) (1) (A) (xiv)

86. Amount of SSI 411 (a) (1) (A) (xiv)

87. Amount of Worker's Compensation 411 (a) (1) (A) (xiv)

88. Amount of Other Unearned Income 411 (a) (1) (A) (xiv)

Child Characteristics Items 89 - 109

89. Family Affiliation 411 (a) (1) (A) (iv) and 411 (b): Needed to identify persons in eligible family receiving assistance and other individuals living in the household.

90. Date of Birth 411 (a) (1) (A) (iii): Age - Date of birth gives the same information but is a constant.

91. Social Security Number This information is also readily available. States use Social Security Numbers to carry out the requirements of IEVS (see sections 409(a)(4) and 1137 of the Act). We need this information also for research on the circumstances of children and families as required in section 413(g) of the Act (i.e., to track individual members of the TANF family).

92. Race 411 (a) (1) (A) (viii)

93. Gender Data could be collected under the element Relationship to Head-of-Household (e.g., husband, wife, daughter, son, etc.). Element was broken out to make the coding cleaner and easier for States to report. Used the Secretary's Report to the Congress.

Receives Federal Disability Benefits

94. Receives Benefits Based on Federal Disability Status 411 (a) (1) (A) (ii) as revised by P.L. 105-33

95. Receives Aid Under Title XVI-SSI 411 (a) (1) (A) (ii) as revised by P.L. 105-33

96. Relationship to Head-of-household 411 (a) (1) (A) (iv) as revised by P.L. 105-33

97. Teen Parent with Child in the Family 411 (a) (1) (A) (xvii) as revised by P.L. 105-33

Child Educational Level Items 101 and 102

98. Highest Level of Education Attained 411 (a) (1) (A) (viii)

99. Highest Degree Attained 411 (a) (1) (A) (viii)

100. Citizenship/Alienage 411 (a) (1) (A) (xv): We have updated our prior coding of citizenship status to reflect TANF; also 409 (a) (1)

101. Cooperation with Child Support 409 (a) (5)

Child Unearned Income Items 105 and 106

102. Amount of SSI 411 (a) (1) (A) (xiv)

103. Amount of Other Unearned Income 411 (a) (1) (A) (xiv) - rather than breaking out unearned income into its parts, we ask for an indicator that the recipient has certain types of unearned income.

Child Care Reporting Section Items 107 - 109

104. Type of Child Care The CCDF sample will not capture children whose child care is funded by TANF. The data element is collected here because it is required under CCDF and this is the most cost-effective way to capture TANF Child Care information. See Sec. 658K (a)(2)(C)

105. Total Monthly Cost of Child Care The CCDF sample will not capture children whose child care is funded by TANF. The data element is collected here because it is required under CCDF and this is the most cost-effective way to capture TANF Child Care information. (See Sec. 658K (a)(2)(C)). The Total Amount of the Child Care Subsidy (required by 411 (a)) may be derived from this item and the total Monthly cost of child Care.

106. Total Monthly Hours of Child Care Provided During the Reporting Month The CCDF sample will not capture children whose child care is funded by TANF. The data element is collected here because it is required under CCDF and this is the most cost-effective way to capture TANF Child Care information. See Sec. 658K (a)(2)(C)

APPENDIX J

Statutory Reference Table for Appendix B

Data Elements Justification

1. State FIPS Code Implicit in administering data collection system

2. County FIPS Code 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

3. Tribal Code Implicit in administering data collection system

4. Reporting Month Implicit in administering data collection system

5. Stratum Implicit in administering data collection system

Family Level Data Items 6 - 16

6. Case Number Implicit in administering data collection system

7. ZIP Code Needed for geographic coding (and rural/urban analyses) and is readily available.

8. Disposition Implicit in administering data collection system

9. Reason for Closure 411 (a) (1) (A) (xvi)

10. Number of Family Members 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

11. Receives Subsidized Housing 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

12. Receives Medical Assistance 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

13. Receives Food Stamps 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

14. Amount of Food Stamp Assistance 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

15. Receives Subsidized Child Care 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

16. Amount of Subsidized Child Care 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

Adult Characteristics items 17 - 39

17. Family Affiliation Needed to identify persons in State-defined family and other individuals living in the household.

18. Date of Birth 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

19. Social Security Number This information is also readily available. States use Social Security Numbers to carry out the requirements of IEVS (see sections 409(a)(4) and 1137 of the Act). We need this information also for research on the circumstances of children and families as required in section 413(g) of the Act (i.e., to track individual members of the TANF family).

20. Race 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

21. Gender Data could be collected under the element Relationship to Head-of-Household (e.g., husband, wife, daughter, son, etc.). Element was broken out to make the coding cleaner and easier for States to report. Used the Secretary's Report to the Congress.

Receives Federal Disability Benefits Items 22 - 26

22. Receives Federal Disability Insurance Benefits 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

23. Receives Benefits Based on Federal Disability Status 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

24. Receives Aid Under Title XIV-APDT 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

25. Receives Aid Under Title XVI-AABD 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

26. Receives Aid Under Title XVI-SSI 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

27. Marital Status 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

28. Relationship to Head-of-Household 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

29. Teen Parent with Child in the Family 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

Adult Educational Level Items 30 and 31

30. Highest Level of Education Attained 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

31. Highest Degree 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

32. Citizenship/Alienage 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A) and 409 (a) (1), for families receiving assistance.

33. Number of Months Countable toward Federal Time Limit in Own State (Tribe) 411 (b): Use to construct comparable statistics based on 409 (a) (9), for families receiving assistance.

34. Number of Months Countable toward Federal Time Limit in Other States or Tribes 411 (b): Use to construct comparable statistics based on 409 (a) (9), for families receiving assistance.

35. Number of Countable Months Remaining Under State's Time Limit 411 (b): Use to construct comparable statistics based on 409 (a) (9), for families receiving assistance.

36. Employment Status 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

Adult Earned Income Items 37 and 38 break out earned income.

37. Earned Income Tax Credit (EITC) 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

38. Wages, Salaries, and Other Earnings 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

39. Unearned Income 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

Child Characteristics Items 40 - 52

40. Family Affiliation Needed to identify persons in State-defined family and other individuals living in the household.

41. Date of Birth 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

42. Social Security Number This information is also readily available. States use Social Security Numbers to carry out the requirements of IEVS (see sections 409(a)(4) and 1137 of the Act). We need this information also for research on the circumstances of children and families as required in section 413(g) of the Act (i.e., to track individual members of the TANF family).

43. Race 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

44. Gender Data could be collected under the element Relationship to Head-of-Household (e.g., husband, wife, daughter, son, etc.). Element was broken out to make the coding cleaner and easier for States to report. Used the Secretary's Report to the Congress.

Receives Federal Disability Benefits Items 45 - 49

45. Receives Benefits Based on Federal Disability Status 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

46. Receives Aid Under Title XVI-SSI 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

47. Relationship to Head-of-Household 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

48. Teen Parent with Child in the Family 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

Child Educational Level Items 52 and 53

49. Highest Level of Education Attained 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

50. Highest Degree 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

51. Citizenship/Alienage 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A) and 409 (a) (1), for families receiving assistance.

52. Cooperation with Child Support 411 (b): Use to construct comparable statistics based on 409 (a) (5), for families receiving assistance.

53. Unearned Income 411 (b): Use to construct comparable statistics based on 411 (a) (1) (A), for families receiving assistance.

APPENDIX K

Statutory Reference Table for Appendix C

Data Elements Statutory Basis

1. State FIPS Code Implicit in administering data collection system

2. Tribal Code Implicit in administering data collection system

3. Calendar Quarter Implicit in administering data collection system

4. Total Number of Applications 411 (b): Use in Report to Congress.

5. Total Number of Approved Applications 411 (a): Implicit in use of samples. Needed to weight sample data report for the newly, approved applicants portion of the sample.

411 (b): Use in Report to Congress.

6. Total Number of Denied Applications 411 (b): Use in Report to Congress.

7. Total Amount of Assistance 411 (a) (6) as revised by P.L. 105-33

8. Total Number of Families 411 (a) (6) as revised by P.L. 105-33

407 (b) (3): Use in calculation of caseload reduction for adjusting the participation rate standard.

411 (a): Implicit in use of samples to weight State data to national totals.

9. Total Number of Recipients 411 (a) (6) as revised by P.L. 105-33

10. Total Number of Adult Recipients 411 (a) (6) as revised by P.L. 105-33

11. Total Number of Child Recipients 411 (a) (6) as revised by P.L. 105-33

12. Total Number of Two-Parent Families 411 (a) (6) as revised by P.L. 105-33

407 (b) (3): Use in calculation of caseload reduction for adjusting the participation rate standard.

13. Total Number of One-Parent Families 411 (a) (6) as revised by P.L. 105-33

14. Total Number of No-Parent Families 411 (a) (6) as revised by P.L. 105-33

15. Total Number of Non-custodial Parents Participating in Work Activities 411 (a) (4)

16. Total Number of Minor Child Heads-of-Household Used to test the reliability and representativeness of the sample.

411 (b): Use in Report to Congress.

17. Total Number of Births 413 (e): Needed to calculate the Annual Ranking of States related to Out-of-Wedlock Births.

18. Total Number of Out-of-Wedlock Births 413 (e): Needed to calculate the Annual Ranking of States related to Out-of-Wedlock Births.

19. Total Number of Closed Cases 411 (a): Implicit in use of samples. Needed to weight sample data report for families no longer receiving assistance.

State	Code	State	Code
Alabama	01	Montana	30
Alaska	02	Nebraska	31
American Samoa	60	Nevada	32
Arizona	04	New Hampshire	33
Arkansas	05	New Jersey	34
California	06	New Mexico	35
Colorado	08	New York	36
Connecticut	09	North Carolina	37
Delaware	10	North Dakota	38
Dist. Of Columbia	11	Ohio	39
Florida	12	Oklahoma	40
Georgia	13	Oregon	41
Guam	66	Pennsylvania	42
Hawaii	15	Puerto Rico	72
Idaho	16	Rhode Island	44
Illinois	17	South Carolina	45
Indiana	18	South Dakota	46
Iowa	19	Tennessee	47
Kansas	20	Texas	48
Kentucky	21	Utah	49
Louisiana	22	Vermont	50
Maine	23	Virgin Islands	78
Maryland	24	Virginia	51
Massachusetts	25	Washington	53
Michigan	26	West Virginia	54
Minnesota	27	Wisconsin	55
Mississippi	28	Wyoming	56
Missouri	29

Temporary Assistance for Needy Families (TANF) ACF - 196 Financial Report
STATE	FISCAL	CURRENT QTR. ENDED	NEXT QTR. ENDING	ANNUAL RECONCILIATION [ ] YES [ ] NO
ITEMS	(A) FEDERAL AWARDS & TRANSFERS	SFAG FUNDS (B)	(C)	CONTINGENCY FUND FEDERAL SHARE AT FY 1995 FMAP RATE OF ______% (D) FEDERAL AWARDS
1. AWARDED	$			$
2. TRANSFERRED TO CCDF DISCRETIONARY	$
3. TRANSFERRED TO SSBG	$
4. AVAILABLE FOR TANF	$
	FEDERAL TANF EXPENDITURES	STATE TANF EXPENDITURES (MOE)	SEPARATE STATE PROGRAMS (MOE)	FEDERAL EXPENDITURES
5. EXPENDITURES ON ASSISTANCE	$	$	$	$
a. CASH ASSISTANCE	$	$	$	$
b. WORK SUBSIDIES	$	$	$	$
c. CHILD CARE	$	$	$	$
d. OTHER	$	$	$	$
6. EXPENDITURES ON NON-ASSISTANCE	$	$	$	$
a. WORK ACTIVITIES	$	$	$	$
b. ADMINISTRATION	$	$	$	$
c. SYSTEMS	$	$	$	$
d. TRANSITIONAL SERVICES FOR EMPLOYED	$	$	$	$
e. OTHER	$	$	$	$
7. OTHER EXPENDITURES	$	$	$	$
8. TOTAL EXPENDITURES	$	$	$	$

9. FEDERAL UNLIQUIDATED OBLIGATIONS	$			$
10. UNOBLIGATED BALANCE	$			$
QUARTERLY ESTIMATE
	TANF FEDERAL FUNDS
11. ESTIMATE FOR NEXT QTR. ENDED	$
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.
SIGNATURE: AUTHORIZED STATE OFFICIAL			TYPED NAME, TITLE, AGENCY NAME
DATE SUBMITTED:	SUBMITTAL: [ ] NEW [ ] REVISED
PAGE 1 OF 1 APPROVED OMB NO. xxxx-xxxx FORM ACF-196 (xx/xx)

Data Elements	Justification
1. State FIPS Code	Implicit in administering data collection system
2. County FIPS Code	411 (a) (1) (A) (i)
3. Tribal Code	Implicit in administering data collection system
4. Reporting Month	Implicit in administering data collection system
5. Stratum	Implicit in administering data collection system
Family Level Data	Items 6 - 44
6. Case Number	Implicit in administering data collection system
7. ZIP Code	Needed for geographic coding (and rural/urban analyses) and is readily available.
8. Funding Stream	411 (a) (1) (A) (xii): Use in calculation of participation rate.
9. Disposition	Implicit in administering data collection system
10. New Applicant	411 (b), requires the Secretary to report to Congress on families applying for TANF assistance. This element identifies applicants that are newly, approved families receiving assistance.
11. Number of Family Members	411 (a) (1) (A) (iv)
12. Type of Family for Work Participation	411 (a) (1) (A) (xii): Use in calculation of participation rate.
13. Receives Subsidized Housing	411 (a) (1) (A) (ix)
14. Receives Medical Assistance	411 (a) (1) (A) (ix)
15. Receives Food Stamps	411 (a) (1) (A) (ix)
16. Amount of Food Stamp Assistance	411 (a) (1) (A) (ix)
17. Receives Subsidized Child Care	411 (a) (1) (A) (ix)
18. Amount of Subsidized Child Care	411 (a) (1) (A) (ix)
19. Amount of Child Care Disregard	The CCDF sample will not capture children whose child care is funded by TANF. The data element is collected here because it is required under CCDF and this is the most cost-effective way to capture TANF Child Care information. (See Sec. 658K (a)(2)(C)).
20. Amount of Child Support	411 (a) (1) (A) (xiv): break-out of unearned income.
21. Amount of the Families' Cash Resources	411 (b), requires the Secretary to report to Congress on financial circumstances of families receiving TANF assistance.
Amount of Assistance Received and Number of Months the Family Received Assistance by Type under the State TANF Program	items 22 - 31 are types of assistance
22. Cash and Cash Equivalents	411 (a) (1) (A) (x) & (xiii)
23. Educational	411 (a) (1) (A) (x) & (xiii)
24. Employment Services	411 (a) (1) (A) (x) & (xiii)
25. Work Subsidies	411 (a) (1) (A) (x) & (xiii)
26. TANF Child Care	411 (a) (1) (A) (x) & (xiii)
27. Transportation	411 (a) (1) (A) (x) & (xiii)
28. Other Supportive Services and Special Needs, Including Assistance with Meeting Home Heating and Air Conditioning Costs	411 (a) (1) (A) (x) & (xiii)
29. Transitional Services	411 (a) (1) (A) (x) & (xiii)
30. Contributions to Individual Development Accounts	411 (a) (1) (A) (x) & (xiii)
31. Other	411 (a) (1) (A) (x) & (xiii)
Reason for and Amount of Reduction in Assistance	Items 32 - 42 are the reasons for reduction in assistance
32. Work Requirements Sanction	411 (a) (1) (A) (xiii)
33. Family Sanction for an Adult with No High School Diploma or Equivalent	411 (a) (1) (A) (xiii)
34. Sanction for Teen Parent Not Attending School	411 (a) (1) (A) (xiii)
35. Non-Cooperation with Child Support	411 (a) (1) (A) (xiii)
36. Failure to Comply with an Individual Responsibility Plan	411 (a) (1) (A) (xiii)
37. Other Sanction	411 (a) (1) (A) (xiii)
38. Recoupment of Prior Overpayment	411 (a) (1) (A) (xiii)
39. Family Cap	411 (a) (1) (A) (xiii)
40. Reduction Based on Family Moving into State From Another State	411 (a) (1) (A) (xiii)
41. Reduction Based on Length of Receipt of Assistance	411 (a) (1) (A) (xiii)
42. Other, Non-sanction	411 (a) (1) (A) (xiii)
43. Waiver Evaluation Research Group	411 (a) (1) (A) (xii): Use to calculate the participation rate for States with an ongoing waiver evaluation for impact analysis purposes
44. Is the TANF Family Exempt from the Federal Time Limit	409 (a) (9)
Adult Characteristics	items 45 - 88
45. Family Affiliation	411 (a) (1) (A) (iv) and 411 (b): Needed to identify persons in eligible family receiving assistance and other individuals living in the household.
46. Noncustodial Parent Indicator	411 (a) (4): Report on Non-custodial Parents requires the number of non-custodial Parents. To provide assistance to non-custodial parents under the State TANF Program, States must include them in the family. Data could be collected under the element Relationship to Head-of-Household. Element was broken out to make the coding cleaner and easier for States to report.
47. Date of Birth	411 (a) (1) (A) (iii): Age - Date of birth gives the same information but is a constant.
48. Social Security Number	This information is also readily available. States use Social Security Numbers to carry out the requirements of IEVS (see sections 409(a)(4) and 1137 of the Act). We need this information also for research on the circumstances of children and families as required in section 413(g) of the Act (i.e., to track individual members of the TANF family).
49. Race	411 (a) (1) (A) (vii)
50. Gender	Data could be collected under the element Relationship to Head-of-Household (e.g., husband, wife, daughter, son, etc.). Element was broken out to make the coding cleaner and easier for States to report. Used the Secretary's Report to the Congress.
Receives Federal Disability Benefits	Items 51 - 55
51. Receives Federal Disability Insurance Benefits	411 (a) (1) (A) (ii) as revised by P.L. 105-33
52. Receives Benefits Based on Federal Disability Status	411 (a) (1) (A) (ii) as revised by P.L. 105-33
53. Receives Aid Under Title XIV-APDT	411 (a) (1) (A) (ii) as revised by P.L. 105-33
54. Receives Aid Under Title XVI-AABD	411 (a) (1) (A) (ii) as revised by P.L. 105-33
55. Receives Aid Under Title XVI-SSI	411 (a) (1) (A) (ii) as revised by P.L. 105-33
56. Marital Status	411 (a) (1) (A) (vi)
57. Relationship to Head-of-Household	411 (a) (1) (A) (iv) as revised by P.L. 105-33
58. Teen Parent with Child in the Family	411 (a) (1) (A) (xvii) as revised by P.L. 105-33

Adult Educational Level	Items 59 and 60
59. Highest Level of Education Attained	411 (a) (1) (A) (vii)
60. Highest Degree Attained	411 (a) (1) (A) (vii)
61. Citizenship /Alienage	411 (a) (1) (A) (xv): We have updated our prior coding of citizenship status to reflect the complexity of TANF; also 409 (a) (1)
62. Number of Months Countable toward Federal Time Limit in Own State (Tribe)	409 (a) (9)
63. Number of Months Countable toward Federal Time Limit in Other States or Tribes	409 (a) (9)
64. Number of Countable Months Remaining Under State's Time Limit	409 (a) (9)
65. Is Current Month Exempt from the State's Time Limit	409 (a) (9)
66. Employment Status	411 (a) (1) (A) (v)
67. Work Participation Status	411 (a) (1) (A) (xii): Needed to calculate the work participation rate.
Adult Work Participation Activities	Items 68 - 81 are the work participation activities and are needed to calculate the work participation rate.
68. Unsubsidized Employment	411 (a) (1) (A) (xi) (III)
69. Subsidized Private Sector Employment	411 (a) (1) (A) (xi) (II)
70. Subsidized Public Sector Employment	411 (a) (1) (A) (xi) (IV)
71. Work Experience	411 (a) (1) (A) (xi) (IV)
72. Onthejob Training	411 (a) (1) (A) (xi) (VI)
73. Job Search and Job Readiness Assistance	411 (a) (1) (A) (xi) (V)
74. Community Service Programs	411 (a) (1) (A) (xi) (IV)
75. Vocational Educational Training	411 (a) (1) (A) (xi) (VII)
76. Job Skills Training Directly Related to Employment	411 (a) (1) (A) (xi) (VI)
77. Education Directly Related to Employment for Individuals with no High School Diploma or Certificate of High School Equivalency	411 (a) (1) (A) (xi) (I)
78. Satisfactory School Attendance for Individuals with no High School Diploma or Certificate of High School Equivalency	411 (a) (1) (A) (xi) (I)
79. Providing Child Care Services to an Individual who is Participating in a Community Service Program	411 (a) (1) (A) (xi)
80. Additional Work Activities Permitted Under Waiver	411 (a) (1) (A) (xii): Use to calculate work participation rate, when approved 1115 waiver permits other work activities.
81. Other Work Activities	Related to 411 (a) (1) (A) (xii) and 409 (a) (3)
82. Required Hours of Work Under Waiver	411 (a) (1) (A) (xii): Use to calculate the Work participation rate, when approved 1115 waiver permits a different number of hours of work participation to count as engaged in work
Adult Earned Income	Items 83 and 84 break out earned income.
83. Earned Income Tax Credit (EITC)	411 (a) (1) (A) (v)
84. Wages, Salaries, and Other Earnings	411 (a) (1) (A) (v)
Adult Unearned Income	Items 85 and 88 break out Unearned income.
85. Amount of Social Security	411 (a) (1) (A) (xiv)
86. Amount of SSI	411 (a) (1) (A) (xiv)
87. Amount of Worker's Compensation	411 (a) (1) (A) (xiv)
88. Amount of Other Unearned Income	411 (a) (1) (A) (xiv)
Child Characteristics	Items 89 - 109
89. Family Affiliation	411 (a) (1) (A) (iv) and 411 (b): Needed to identify persons in eligible family receiving assistance and other individuals living in the household.
90. Date of Birth	411 (a) (1) (A) (iii): Age - Date of birth gives the same information but is a constant.
91. Social Security Number	This information is also readily available. States use Social Security Numbers to carry out the requirements of IEVS (see sections 409(a)(4) and 1137 of the Act). We need this information also for research on the circumstances of children and families as required in section 413(g) of the Act (i.e., to track individual members of the TANF family).
92. Race	411 (a) (1) (A) (viii)
93. Gender	Data could be collected under the element Relationship to Head-of-Household (e.g., husband, wife, daughter, son, etc.). Element was broken out to make the coding cleaner and easier for States to report. Used the Secretary's Report to the Congress.
Receives Federal Disability Benefits
94. Receives Benefits Based on Federal Disability Status	411 (a) (1) (A) (ii) as revised by P.L. 105-33
95. Receives Aid Under Title XVI-SSI	411 (a) (1) (A) (ii) as revised by P.L. 105-33
96. Relationship to Head-of-household	411 (a) (1) (A) (iv) as revised by P.L. 105-33
97. Teen Parent with Child in the Family	411 (a) (1) (A) (xvii) as revised by P.L. 105-33
Child Educational Level	Items 101 and 102
98. Highest Level of Education Attained	411 (a) (1) (A) (viii)
99. Highest Degree Attained	411 (a) (1) (A) (viii)
100. Citizenship/Alienage	411 (a) (1) (A) (xv): We have updated our prior coding of citizenship status to reflect TANF; also 409 (a) (1)
101. Cooperation with Child Support	409 (a) (5)
Child Unearned Income	Items 105 and 106
102. Amount of SSI	411 (a) (1) (A) (xiv)
103. Amount of Other Unearned Income	411 (a) (1) (A) (xiv) - rather than breaking out unearned income into its parts, we ask for an indicator that the recipient has certain types of unearned income.
Child Care Reporting Section	Items 107 - 109
104. Type of Child Care	The CCDF sample will not capture children whose child care is funded by TANF. The data element is collected here because it is required under CCDF and this is the most cost-effective way to capture TANF Child Care information. See Sec. 658K (a)(2)(C)
105. Total Monthly Cost of Child Care	The CCDF sample will not capture children whose child care is funded by TANF. The data element is collected here because it is required under CCDF and this is the most cost-effective way to capture TANF Child Care information. (See Sec. 658K (a)(2)(C)). The Total Amount of the Child Care Subsidy (required by 411 (a)) may be derived from this item and the total Monthly cost of child Care.
106. Total Monthly Hours of Child Care Provided During the Reporting Month	The CCDF sample will not capture children whose child care is funded by TANF. The data element is collected here because it is required under CCDF and this is the most cost-effective way to capture TANF Child Care information. See Sec. 658K (a)(2)(C)

Data Elements	Statutory Basis
1. State FIPS Code	Implicit in administering data collection system
2. Tribal Code	Implicit in administering data collection system
3. Calendar Quarter	Implicit in administering data collection system
4. Total Number of Applications	411 (b): Use in Report to Congress.
5. Total Number of Approved Applications	411 (a): Implicit in use of samples. Needed to weight sample data report for the newly, approved applicants portion of the sample. 411 (b): Use in Report to Congress.
6. Total Number of Denied Applications	411 (b): Use in Report to Congress.
7. Total Amount of Assistance	411 (a) (6) as revised by P.L. 105-33
8. Total Number of Families	411 (a) (6) as revised by P.L. 105-33 407 (b) (3): Use in calculation of caseload reduction for adjusting the participation rate standard. 411 (a): Implicit in use of samples to weight State data to national totals.
9. Total Number of Recipients	411 (a) (6) as revised by P.L. 105-33
10. Total Number of Adult Recipients	411 (a) (6) as revised by P.L. 105-33
11. Total Number of Child Recipients	411 (a) (6) as revised by P.L. 105-33
12. Total Number of Two-Parent Families	411 (a) (6) as revised by P.L. 105-33 407 (b) (3): Use in calculation of caseload reduction for adjusting the participation rate standard.
13. Total Number of One-Parent Families	411 (a) (6) as revised by P.L. 105-33
14. Total Number of No-Parent Families	411 (a) (6) as revised by P.L. 105-33
15. Total Number of Non-custodial Parents Participating in Work Activities	411 (a) (4)
16. Total Number of Minor Child Heads-of-Household	Used to test the reliability and representativeness of the sample. 411 (b): Use in Report to Congress.
17. Total Number of Births	413 (e): Needed to calculate the Annual Ranking of States related to Out-of-Wedlock Births.
18. Total Number of Out-of-Wedlock Births	413 (e): Needed to calculate the Annual Ranking of States related to Out-of-Wedlock Births.
19. Total Number of Closed Cases	411 (a): Implicit in use of samples. Needed to weight sample data report for families no longer receiving assistance.