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Child Advocate Referral (Form L-12A) - Recordkeepers
Legal and Advocacy Services for Unaccompanied Children
OMB: 0970-0565
IC ID: 271731
OMB.report
HHS/ACF
OMB 0970-0565
ICR 202410-0970-008
IC 271731
( )
Documents and Forms
Document Name
Document Type
Form Form L-12A
Child Advocate Referral (Form L-12A) - Recordkeepers
Form and Instruction
Form L-12A Child Advocate Referral
L-12A Child Advocate Referral_v4_Final Draft - TRANSFERRED & REVISED.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Child Advocate Referral (Form L-12A) - Recordkeepers
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Mandatory
CFR Citation:
45 CFR § 410.1308 (To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
Form L-12A
Child Advocate Referral
L-12A Child Advocate Referral_v4_Final Draft - TRANSFERRED & REVISED.pdf
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:
1
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 %
Requested
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
5,601
0
5,601
0
0
0
Annual IC Time Burden (Hours)
1,848
0
1,848
0
0
0
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.