Unlicensed Facility Unaccompanied Child Questionnaires (M-12A-UF to M-12B-UF & M-12E-UF) - Recordkeeping

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

OMB: 0970-0564

IC ID: 256790

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Unlicensed Facility Unaccompanied Child Questionnaires (M-12A-UF to M-12B-UF & M-12E-UF) - Recordkeeping
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form M-12A-UF Unlicensed Facility Unaccompanied Child Questionnaire - Ages 6-12 Years Old English M-12A-UF UC Questionnaire - Ages 6-12 Years Old English.docx Yes Yes Fillable Fileable
Form and Instruction Form M-12As-UF Unlicensed Facility Unaccompanied Child Questionnaire - Ages 6-12 Years Old Spanish M-12As-UF UC Questionnaire - Ages 6-12 Years Old Spanish.docx Yes Yes Fillable Fileable
Form and Instruction Form M-12B-UF Unlicensed Facility Unaccompanied Child Questionnaire - Ages 13 and Older English M-12B-UF UC Questionnaire - Ages 13 and Older English.docx Yes Yes Fillable Fileable
Form and Instruction Form M-12Bs-UF Unlicensed Facility Unaccompanied Child Questionnaire - Ages 13 and Older Spanish M-12Bs-UF UC Questionnaire - Ages 13 and Older Spanish.docx Yes Yes Fillable Fileable
Form and Instruction Form M-12E-UF Unlicensed Facility Unaccompanied Child Questionnaire - Ages 5 and Under - English M-12E-UF UC Questionnaire - Ages 5 and Under - English.docx Yes Yes Fillable Fileable
Form and Instruction Form M-12Es-UF Unlicensed Facility Unaccompanied Child Questionnaire - Ages 5 and Under Spanish M-12Es-UF UC Questionnaire - Ages 5 and Under Spanish.docx Yes Yes Fillable Fileable

Community and Social Services Social Services

ORR Unaccompanied Refugee Minors Records  81 FR 46682

18 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,116 0 0 0 0 1,116
Annual IC Time Burden (Hours) 558 0 0 0 0 558
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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