Unaccompanied Refugee Minors Program Application

Unaccompanied Refugee Minors Program Application, and Withdrawal of Application or Declination of Placement Form

Documents and Forms

Document Name Document Type
Form 1 Unaccompanied Refugee Minors Program Application Form
1 URM Program Application Form Unaccompanied Refugee Minors Program Application_CLEAN.docx Form
1 URM Program Application Form Unaccompanied Refugee Minors Program Application_UPDATED 7.6.2023.docx Form

Information Collection (IC) Details

IC Title:	Unaccompanied Refugee Minors Program Application	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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	URM Program Application Form	Unaccompanied Refugee Minors Program Application_UPDATED 7.6.2023.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: ORR’s Refugee Arrivals Data System (RADS)	FR Citation: 87 FR 7178

Number of Respondents: 450	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	450	100	350
Annual IC Time Burden (Hours)	675	150	525
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.