Long Term Foster Care Client Questionnaire (M-12C) - Respondents

Monitoring and Compliance for Office of Refugee Resettlement (ORR) Care Provider Facilities

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0564 can be found here:

Documents and Forms

Document Name Document Type
Form Form M-12C Long Term Foster Care Client Questionnaire (M-12C) - Respondents Form and Instruction
Form M-12C LTFC Client Questionnaire 46 - LTFC Client Questionnaire (Form M-12C).docx Form and Instruction
Form M-12C LTFC Client Questionnaire 46 - LTFC Client Questionnaire (Form M-12C).docx Form and Instruction

Information Collection (IC) Details

IC Title:	Long Term Foster Care Client Questionnaire (M-12C) - Respondents	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	Form M-12C	LTFC Client Questionnaire	46 - LTFC Client Questionnaire (Form M-12C).docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 75	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	75	75
Annual IC Time Burden (Hours)	38	38
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.