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Request for Specific Consent to Junenile Court Jurisdiction
Request for Specific Consent to Juvenile Court Jurisdiction
OMB: 0970-0385
IC ID: 195192
OMB.report
HHS/ACF
OMB 0970-0385
ICR 201011-0970-003
IC 195192
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0385 can be found here:
2018-03-14 - Reinstatement without change of a previously approved collection
2014-03-28 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Request for Specific Consent to Junenile Court Jurisdiction
Form and Instruction
1 Interim Request for Specific Consent to Juvenile Court J
Specific Consent FORM INTERIM (9).doc
Form and Instruction
Special_Immigrant_Juvenile_Status-Interim_Specific_Consent_Program_Instructions.pdf
Program Instruction
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Request for Specific Consent to Junenile Court Jurisdiction
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:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
1
Interim Request for Specific Consent to Juvenile Court Jurisdiction
Specific Consent FORM INTERIM (9).doc
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Litigation and Judicial Activities
Subfunction:
Judicial Hearing
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
72
Number of Respondents for Small Entity:
72
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
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
72
0
72
0
0
0
Annual IC Time Burden (Hours)
24
0
24
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Program Instruction
Special_Immigrant_Juvenile_Status-Interim_Specific_Consent_Program_Instructions.pdf
09/27/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.