FFS Compliance and Safety Site Visit Report (Form M-3A) - Respondents

Monitoring and Compliance for Office of Refugee Resettlement (ORR) Care Provider Facilities

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0564 can be found here:

Documents and Forms

Document Name Document Type
Form Form M-3A FFS Compliance and Safety Site Visit Report (Form M-3A) - Respondents Form and Instruction
Form M-3A FFS Compliance and Safety Site Visit Report M-3A FFS Compliance and Safety Site Visit Report.pdf Form and Instruction
Form M-3A FFS Compliance and Safety Site Visit Report M-3A FFS Compliance and Safety Site Visit Report.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	FFS Compliance and Safety Site Visit Report (Form M-3A) - Respondents	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 and Instruction	Form M-3A	FFS Compliance and Safety Site Visit Report	M-3A FFS Compliance and Safety Site Visit Report.pdf		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 262	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: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,144	552	2,592
Annual IC Time Burden (Hours)	3,144	552	2,592
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.