Information Collection

Authorization for Release of Information

IC 185522 under ICR 200806-0970-002 · OMB 0970-0278.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0278 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ORR R-317 Page 1 Authorization for Release of Information	Form
ORR R-317 Page 1 Authorization for Release of Information/English Page 1 Authorization for Release of Information-Page 1- English.doc	Form
ORR R-317 Authorization for Release Information/English Page 2 Authorization for Release of Information-Page 2- English.doc	Form
ORR R-317s Authorization for Release Information/Spanish/Page 1 Authorization for Release of Information-Page 1-Spanish.doc	Form
ORR-317s Authorization for Release of Information/Spanish/Page 2 Authorization for Release of Information-Page 2-Spanish.doc	Form

IC Title:

Authorization for Release of Information

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ORR R-317 Page 1	Authorization for Release of Information/English Page 1	Authorization for Release of Information-Page 1- English.doc	Yes	Yes	Paper Only
Form	ORR R-317	Authorization for Release Information/English Page 2	Authorization for Release of Information-Page 2- English.doc	Yes	Yes	Paper Only
Form	ORR R-317s	Authorization for Release Information/Spanish/Page 1	Authorization for Release of Information-Page 1-Spanish.doc	Yes	Yes	Paper Only
Form	ORR-317s	Authorization for Release of Information/Spanish/Page 2	Authorization for Release of Information-Page 2-Spanish.doc	Yes	Yes	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,288

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	64,320	64,320
Annual IC Time Burden (Hours)	1,428	1,428
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.