Notice of Placement in a Restrictive Setting (Form P-4)

Placement and Transfer of Unaccompanied Children into ORR Care Provider Facilities

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0554 can be found here:

Documents and Forms

Document Name Document Type
Form P-4 Notice of Placement in a Restrictive Setting (Form P-4) Form and Instruction
P-4 Notice of Placement in a Restrictive Setting (English) Notice of Placement in a Restrictive Setting (Form P-4) English.pdf Form and Instruction
P-4 Notice of Placement in a Restrictive Setting (English) Notice of Placement in a Restrictive Setting (Form P-4) English.pdf Form and Instruction
P-4 (ESP) Notice of Placement in a Restrictive Setting (Spanish) TR109_P-4 (ESP) Notice of Placement in a Restrictive Setting_v6_Spanish_DRAFT.docx Form and Instruction
P-4 (ESP) Notice of Placement in a Restrictive Setting (Spanish) TR109_P-4 (ESP) Notice of Placement in a Restrictive Setting_v6_Spanish_DRAFT.docx Form and Instruction
P-4 (PRS) Notice of Placement in a Restrictive Setting (Dari) TR109_P-4 (PRS) Notice of Placement in a Restrictive Setting_v6_Dari Persian_DRAFT.docx Form and Instruction
P-4 (PRS) Notice of Placement in a Restrictive Setting (Dari) TR109_P-4 (PRS) Notice of Placement in a Restrictive Setting_v6_Dari Persian_DRAFT.docx Form and Instruction
P-4 (PUS) Notice of Placement in a Restrictive Setting (Pashto) TR109_P-4 (PUS) Notice of Placement in a Restrictive Setting_v6_Pashto_DRAFT.docx Form and Instruction
P-4 (PUS) Notice of Placement in a Restrictive Setting (Pashto) TR109_P-4 (PUS) Notice of Placement in a Restrictive Setting_v6_Pashto_DRAFT.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Notice of Placement in a Restrictive Setting (Form P-4)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	P-4	Notice of Placement in a Restrictive Setting (English)	Notice of Placement in a Restrictive Setting (Form P-4) English.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	P-4 (ESP)	Notice of Placement in a Restrictive Setting (Spanish)	TR109_P-4 (ESP) Notice of Placement in a Restrictive Setting_v6_Spanish_DRAFT.docx	Yes	Yes	Fillable Fileable
Form and Instruction	P-4 (PRS)	Notice of Placement in a Restrictive Setting (Dari)	TR109_P-4 (PRS) Notice of Placement in a Restrictive Setting_v6_Dari Persian_DRAFT.docx	Yes	Yes	Fillable Fileable
Form and Instruction	P-4 (PUS)	Notice of Placement in a Restrictive Setting (Pashto)	TR109_P-4 (PUS) Notice of Placement in a Restrictive Setting_v6_Pashto_DRAFT.docx	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: 09-80-0321 ORR Division of Children's Services Records	FR Citation: 81 FR 46682

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,710	1,200	510
Annual IC Time Burden (Hours)	564	394	170
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.