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UC Assessment (Form S-11)
Services Provided to Unaccompanied Children
OMB: 0970-0553
IC ID: 242809
OMB.report
HHS/ACF
OMB 0970-0553
ICR 202408-0970-008
IC 242809
( )
Documents and Forms
Document Name
Document Type
Form S-11
UC Assessment (Form S-11)
Form and Instruction
Form S-11
UC Assessment (Form S-11)
Form and Instruction
S-11 UC Assessment - UC Path Version
UC Assessment (Form S-11) - UC Path.pdf
Form and Instruction
S-11 UC Assessment - UC Path Version
UC Assessment (Form S-11) - UC Path.pdf
Form and Instruction
S-11 UC Assessment - UC Portal Version
S-11 UC Assessment - New UC Portal.docx
Form and Instruction
S-11 UC Assessment - UC Portal Version
S-11 UC Assessment - New UC Portal.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
UC Assessment (Form S-11)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
S-11
UC Assessment - UC Path Version
UC Assessment (Form S-11) - UC Path.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
S-11
UC Assessment - UC Portal Version
S-11 UC Assessment - New UC Portal.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
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:
216
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
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
60,048
0
0
0
0
60,048
Annual IC Time Burden (Hours)
120,096
0
0
0
0
120,096
Annual IC Cost Burden (Dollars)
0
0
0
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.