|
|
|
|
|
|
OMB No. 0970-0311 |
|
|
|
|
|
|
Expiration Date: 10-31-09 |
| TANF Agency NDNH Match Results |
|
|
|
|
|
|
|
| FY |
|
Quarter |
|
Amended |
|
|
| State: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1. |
2. |
3. |
4. |
| Match Type |
Quarter |
Month |
Unduplicated Individuals Verified as Employed |
Unduplicated TANF Cases Closed Due to Earnings |
Unduplicated TANF Cases with Benefits Reduced |
Unduplicated First Month Avoided TANF Costs |
| W-4 Data Match |
Quarter 1 |
Oct |
|
|
|
|
| Nov |
|
|
|
|
| Dec |
|
|
|
|
| Quarter 2 |
Jan |
|
|
|
|
| Feb |
|
|
|
|
| Mar |
|
|
|
|
| Quarter 3 |
Apr |
|
|
|
|
| May |
|
|
|
|
| Jun |
|
|
|
|
| Quarter 4 |
Jul |
|
|
|
|
| Aug |
|
|
|
|
| Sep |
|
|
|
|
| QW Data Match |
Quarter 1 |
Oct |
|
|
|
|
| Quarter 2 |
Jan |
|
|
|
|
| Quarter 3 |
Apr |
|
|
|
|
| Quarter 4 |
Jul |
|
|
|
|
| UI Data Match |
Quarter 1 |
Oct |
|
|
|
|
| Quarter 2 |
Jan |
|
|
|
|
| Quarter 3 |
Apr |
|
|
|
|
| Quarter 4 |
Jul |
|
|
|
|
Unduplicated
Annual Total |
|
0 |
0 |
0 |
$- |
|
|
|
|
|
|
|
| “Unduplicated” means counting the same person no more than once per fiscal year. Individuals should only be counted in one of the three data sources. |
|
|
|
|
|
|
|
| Please see instructions on page two for an explanation of the four performance measures. |
|
|
|
|
|
|
|
| (Page 2 of PDF File) |
| Instructions |
|
|
|
|
|
|
|
|
|
|
|
|
|
| General Instructions |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Report all outcomes in the month of the match, not the month of verification or case action. Data is to be reported 45 days after the end of each quarter. Data reported in prior quarterly submissions can be updated in subsequent quarterly submissions. |
|
|
|
|
|
|
|
| Previously Unknown Employment |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Item 1. |
Unduplicated Individuals Verified as Employed (or receiving unemployment benefits): The number of unduplicated individuals with previously unknown employment that had a NDNH match and were verified as being employed while they were a TANF recipient in your State. |
|
|
|
|
|
|
|
| Actions Taken |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Item 2. |
Unduplicated TANF Cases Closed Due to Earnings: The number of unduplicated individuals reported in item 1 whose TANF grant was closed as a result of employment verified from an NDNH match. |
|
|
|
|
|
|
|
| Item 3. |
Unduplicated TANF Cases with Benefits Reduced: The number of unduplicated individuals reported in item 1 whose TANF grant was reduced as a result of employment verified from an NDNH match. |
|
|
|
|
|
|
|
| Avoided Costs |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Item 4. |
Unduplicated First-Month Avoided TANF Costs: Total first-month TANF costs avoided from items 2 and 3. |
|
|
|
|
|
|
|
| Unduplicated Annual Total |
|
|
|
|
|
|
|
|
|
|
|
|
|
| The unduplicated annual total equals the sum of each column. The total for item 4 represents the annual unduplicated first-month avoided TANF costs resulting from use of the NDNH. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) Public reporting burden for this collection of information is estimated to average 0.17 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. |
| An agency may not conduct or sponsor, and a person is not arquired to respond to, a collection of information unless it displays a currenly valid OMB control number. |