Information Collection

Summary Notes Thirty Day Restrictive Placement Case Review (Form S-16)

IC 242814 under ICR 202012-0970-009 · OMB 0970-0553.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0553 can be found here:

Documents and Forms

Document Name Document Type
Form S-16 Summary Notes Thirty Day Restrictive Placement Case Review (Form S-16) Form
S-16 Summary Notes Thirty Day Restrictive Placement Case Revi TAB M - Summary Notes Thirty Day Restrictive Placement Case Review (Form S-16).pdf Form
S-16 Summary Notes Thirty Day Restrictive Placement Case Revi TAB M - Summary Notes Thirty Day Restrictive Placement Case Review (Form S-16).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Summary Notes Thirty Day Restrictive Placement Case Review (Form S-16)	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	S-16	Summary Notes Thirty Day Restrictive Placement Case Review	TAB M - Summary Notes Thirty Day Restrictive Placement Case Review (Form S-16).pdf		Yes	Yes	Fillable Fileable

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: 15	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	Previously Approved
Annual Number of Responses for this IC	1,020	1,020
Annual IC Time Burden (Hours)	510	510
Annual IC Cost Burden (Dollars)	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.