Attachment C 4.14.2016 –Revised CERTIFICATION OF TRIBAL POPULATION UNDER AGE 21 the population of children and The (tribal name and state) finds that the Census Bureau’s 2010 data on youth under age 21 for tribes (published as Attachment B to Program Instruction , issued on December 11, 2015) do not accurately reflect the actual number of children eligible for services under our tribe’s title IV-B program. The correct number of tribal children under age 21 eligible for services under our IV-B plan is tribe’s title This information includes: (check all that apply) Children under age 21 the reservation or the title IV-B service area: living on or near tribe’s who are enrolled members of the tribe, eligible for enrollment, or recognized as children for which the tribe is responsible, as determined by the tribe; Other American Indian or Alaska Native children under age 21 provided that these children will be eligible for services under the program; tribe’s title IV-B Children under age 21 not living on or near the reservation or the title IV-B service area: tribe’s who are enrolled members of the tribe, eligible for enrollment, or recognized as children for which the tribe is responsible, as determined by the tribe, provided the tribe describes how the children would participate in the program. tribe’s title IV-B In the space below, please provide a brief description of how children who are not residing on or near the reservation or tribal lands will be served under the plan. (Attach tribe’s title IV-B additional sheets if necessary.) If the reservation, including trust lands, are located in more than one state, please list tribe’s below each state in which the lands are located and the number of children included in the tribe’s population count who reside in each if those states.
Attachment C –Revised 4.14.2016 CERTIFICATION OF TRIBAL POPULATION UNDER AGE 21 The (tribal name and state) finds that the Census Bureau’s 2010 data on the population of children and youth under age 21 for tribes (published as Attachment B to Program Instruction , issued on December 11, 2015) do not accurately reflect the actual number of children eligible for services under our tribe’s title IV-B program. The correct number of tribal children under age 21 eligible for services under our tribe’s title IV-B plan is This information includes: (check all that apply) Children under age 21 living on or near the tribe’s reservation or the title IV-B service area: who are enrolled members of the tribe, eligible for enrollment, or recognized as children for which the tribe is responsible, as determined by the tribe; Other American Indian or Alaska Native children under age 21 provided that these children will be eligible for services under the tribe’s title IV-B program; Children under age 21 not living on or near the tribe’s reservation or the title IV-B service area: who are enrolled members of the tribe, eligible for enrollment, or recognized as children for which the tribe is responsible, as determined by the tribe, provided the tribe describes how the children would participate in the tribe’s title IV-B program. In the space below, please provide a brief description of how children who are not residing on or near the reservation or tribal lands will be served under the tribe’s title IV-B plan. (Attach additional sheets if necessary.) If the tribe’s reservation, including trust lands, are located in more than one state, please list below each state in which the tribe’s lands are located and the number of children included in the population count who reside in each if those states.
pi1604_attachment_c.docx