DEPARTMENT OF HEALTH AND HUMAN SERVICES OMB Approval No.: 0970-0004
Administration for Children and Families Expires: 11/30/2008
Form ACF-4125 DESTROY PRIOR EDITIONS
ANNUAL STATISTICAL REPORT ON
CHILDREN IN FOSTER HOMES AND CHILDREN IN FAMILIES RECEIVING PAYMENTS
IN EXCESS OF THE POVERTY INCOME LEVEL
FROM A STATE PROGRAM FUNDED UNDER PART A OF
TITLE IV OF THE SOCIAL SECURITY ACT
State: PUERTO RICO State Agency ___________________________
Report for the month of October 2008
Prepared by:
Name __________________________________________________
Title ___________________________________________________
Signature_______________________________________________
Compiled by:
Name __________________________________________________
Phone # ________________________________________________
Email address____________________________________________
Part I.
NUMBER OF CHILDREN AGED 5-17 IN FOSTER HOMES
State total _______________
(if entry is greater than zero (0), attach a separate list in the following format.)
Children Aged 5-17 in Foster Homes
A. by COUNTY B. by LOCAL EDUCATIONAL AGENCY (LEA)
County name FIPS County Code Number LEA name LEA Code (Agency ID) Number
Part II .
NUMBER OF CHILDREN AGED 5-17 IN FAMILIES RECEIVING PAYMENTS IN EXCESS OF
THE AMOUNT SPECIFIED FOR THIS REPORT PERIOD FROM A STATE PROGRAM FUNDED UNDER
PART A OF TITLE IV OF THE SOCIAL SECURITY ACT
State total _______________
(if entry is greater than zero (0), attach a separate list in the following format.)
Children Aged 5-17 in FAMILIES RECEIVING PAYMENTS IN EXCESS OF $1,766.67
A. by COUNTY B. by LOCAL EDUCATIONAL AGENCY (LEA)
County name FIPS County Code Number LEA name LEA Code Number
2
Number of children ages 5 - 17, inclusive in foster homes and in families above poverty receiving assistance under TANF
NAME OF STATE: PUERTO RICO
October 2008 October 2007 October 2008 October 2007
Number of Number of Number of Children Ages 5-17 Number of Children Ages 5-17
State Name of Children Ages 5-17 Children Ages 5-17 in Families Above Poverty in Families Above Poverty
State Code LEA Code Local Educational Agency (LEA) In Foster Homes In Foster Homes Receiving Payments Under TANF Receiving Payments Under TANF
PR 72 7200030 PUERTO RICO DEPT. OF EDUCATION 4,497 0
TOTAL FOR STATE 0 4,497 0 0
Number of children ages 5 - 17, inclusive in foster homes and in families above poverty receiving assistance under TANF
NAME OF STATE: PUERTO RICO
October 2008 October 2008
Number of Number of Children Ages 5-17
State County Name of Children Ages 5-17 in Families Above Poverty
State Code Code County In Foster Homes Receiving Payments Under TANF
PR 72 72001 PUERTO RICO
STATE TOTAL