Information Collection Request

Administration and Oversight of the Unaccompanied Children Program

ICR 202109-0970-014 · OMB 0970-0547 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Form A-7 Notification of Concern Form New Available
Form Form A-7 Notification of Concern (Form A-7) Form New Repair queued
Form A-5s Authorization for Release of Records - Spanish Form New Available
Form A-5 Authorization for Release of Records Form New Available
Form A-5 Authorization for Release of Records (Form A-5) - Record keeping Form New Repair queued
Form Form A-1A Care Provider Facility Tour Request Form Modified Available
Form Form A-1A Care Provider Facility Tour Request (Form A-1A) - Record Keeping Form Modified Repair queued
Form Form A-15 ORR Waiver Request Form Modified Available
Form Form A-15 ORR Waiver Request (Form A-15) Form Modified Repair queued
Form A-14 Key Personnel Qualification Checklist and Attestation Form Modified Available
Form A-14 Key Personnel Minimum Qualifications Checklist and Attestation (Form A-14) Form Modified Repair queued
Form A-10D Program-Level Event Report and Addendum - UC Path Version Form Modified Available
Form A-10D Program-Level Event Report - UC Portal Version Form Modified Available
Form A-10D Program Level Event (Form A-10D) Form Modified Repair queued
Form A-10C Significant Incident Report - UC Portal Version Form Modified Available
Form A-10C Significant Incident Report - UC Path Version Form Modified Available
Form A-10C Significant Incident Report (Form A-10C) Form Modified Repair queued
Form A-10B Emergency Significant Incident Report Addendum - UC Portal Version Form Modified Available
Form A-10B Emergency Significant Incident Report Addendum - UC Path Version Form Modified Available
Form A-10B Emergency Significant Incident Report Addendum (Form A-10B) Form Modified Repair queued
Form A-10A Emergency SIR and Addendum - UC Portal Version Form Modified Available
Form A-10A Emergency Significant Incident Report - UC Path Version Form Modified Repair queued
Form A-10A Emergency Significant Incident Report (Form A-10A) Form Modified Repair queued
Form A-9 Event Report Form Modified Available
Form A-9 Event (Form A-9) Form Modified Repair queued
Form A-5s Authorization for Release of Records - Spanish Form Modified Available
Form A-5 Authorization for Release of Records Form Modified Available
Form A-5 Authorization for Release of Records (Form A-5) Form Modified Repair queued
Form A-4s Notice to UC for Flores Visits - Spanish Form Modified Available
Form A-4 Notice to UC for Flores Visits Form Modified Available
Form A-4 Notice to UAC for Flores Visits (Forms A-4 & A-4s) Form Modified Repair queued
Form A-1A Care Provider Facility Tour Request Form Modified Available
Form A-1A Care Provider Facility Tour Request (Form A-1A) Form Modified Repair queued
Attachment A - Admin and Oversight (09.21.21) FINAL.docx Supplementary Document Uploaded 2021-09-24 Repair queued
Supporting Statement - Admin and Oversight (09.21.21) FINAL.docx Supporting Statement A Uploaded 2021-09-24 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
249481 Notification of Concern (Form A-7) Form NewNotification of Concern
249481 Notification of Concern (Form A-7) Form New
249480 Authorization for Release of Records (Form A-5 & A-5s) - Record keeping Form NewAuthorization for Release of Records - Spanish
249480 Authorization for Release of Records (Form A-5 & A-5s) - Record keeping Form NewAuthorization for Release of Records
249480 Authorization for Release of Records (Form A-5) - Record keeping Form New
241082 Care Provider Facility Tour Request (Form A-1A) - Record Keeping Form ModifiedCare Provider Facility Tour Request
241082 Care Provider Facility Tour Request (Form A-1A) - Record Keeping Form Modified
241079 ORR Waiver Request (Form A-15) Form ModifiedORR Waiver Request
241079 ORR Waiver Request (Form A-15) Form Modified
241078 Key Personnel Minimum Qualifications Checklist and Attestation (Form A-14) Form ModifiedKey Personnel Qualification Checklist and Attestation
241078 Key Personnel Minimum Qualifications Checklist and Attestation (Form A-14) Form Modified
241077 Program Level Event (Form A-10D) Form ModifiedProgram-Level Event Report and Addendum - UC Path Version
241077 Program Level Event (Form A-10D) Form ModifiedProgram-Level Event Report - UC Portal Version
241077 Program Level Event (Form A-10D) Form Modified
241076 Significant Incident Report (Form A-10C) Form ModifiedSignificant Incident Report - UC Portal Version
241076 Significant Incident Report (Form A-10C) Form ModifiedSignificant Incident Report - UC Path Version
241076 Significant Incident Report (Form A-10C) Form Modified
241075 Emergency Significant Incident Report Addendum (Form A-10B) Form ModifiedEmergency Significant Incident Report Addendum - UC Portal Version
241075 Emergency Significant Incident Report Addendum (Form A-10B) Form ModifiedEmergency Significant Incident Report Addendum - UC Path Version
241075 Emergency Significant Incident Report Addendum (Form A-10B) Form Modified
241074 Emergency Significant Incident Report (Form A-10A) Form ModifiedEmergency SIR and Addendum - UC Portal Version
241074 Emergency Significant Incident Report (Form A-10A) Form ModifiedEmergency Significant Incident Report - UC Path Version
241074 Emergency Significant Incident Report (Form A-10A) Form Modified
241073 Event (Form A-9) Form ModifiedEvent Report
241073 Event (Form A-9) Form Modified
241072 Authorization for Release of Records (Form A-5 & A-5s) Form ModifiedAuthorization for Release of Records - Spanish
241072 Authorization for Release of Records (Form A-5 & A-5s) Form ModifiedAuthorization for Release of Records
241072 Authorization for Release of Records (Form A-5) Form Modified
241070 Notice to UAC for Flores Visits (Forms A-4 & A-4s) Form ModifiedNotice to UC for Flores Visits - Spanish
241070 Notice to UAC for Flores Visits (Forms A-4 & A-4s) Form ModifiedNotice to UC for Flores Visits
241070 Notice to UAC for Flores Visits (Forms A-4 & A-4s) Form Modified
241067 Care Provider Facility Tour Request (Form A-1A) Form ModifiedCare Provider Facility Tour Request
241067 Care Provider Facility Tour Request (Form A-1A) Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2025 36 Months From Approved 01/31/2024
180,529 0 124,940
132,577 0 38,341
0 0 0





Reginfo record details
13
table that charts list of burden
IC Title Form No. Form Name
Authorization for Release of Records (Form A-5 & A-5s) A-5, A-5s ,  
Authorization for Release of Records (Form A-5 & A-5s) - Record keeping A-5, A-5s ,  
Care Provider Facility Tour Request (Form A-1A) A-1A
Care Provider Facility Tour Request (Form A-1A) - Record Keeping Form A-1A
Emergency Significant Incident Report (Form A-10A) A-10A, A-10A ,  
Emergency Significant Incident Report Addendum (Form A-10B) A-10B, A-10B ,  
Event (Form A-9) A-9
Key Personnel Minimum Qualifications Checklist and Attestation (Form A-14) A-14
Notice to UAC for Flores Visits (Forms A-4 & A-4s) A-4s, A-4 ,  
Notification of Concern (Form A-7) Form A-7
ORR Waiver Request (Form A-15) Form A-15
Program Level Event (Form A-10D) A-10D, A-10D ,  
Significant Incident Report (Form A-10C) A-10C, A-10C ,  

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 180,529 124,940 0 51,589 4,000 0
Annual Time Burden (Hours) 132,577 38,341 0 93,236 1,000 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No