Services for Survivors of Torture Medical Care Survey

Formative Data Collections for ACF Program Support

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Document Name Document Type
ORR-SOT Program_Medical Care Survey_2022_Final_OMB_clean.docx Other-Survey
ORR-SOT Program_Medical Care Survey_2022_Final_OMB_clean.docx Other-Survey
ORR-SOT Medical Care Survey SSA - Formative for ACF Program Support_6.28.22.docx SSA - ORR SOT Medical Care Survey GenIC IC Document
ORR-SOT Medical Care Survey SSA - Formative for ACF Program Support_6.28.22.docx SSA - ORR SOT Medical Care Survey GenIC IC Document
NOA_ORR SOT Form GenIC ProgSupp_0970-0531_7.6.22.pdf NOA - ORR SOT Medical Care Survey GenIC IC Document
NOA_ORR SOT Form GenIC ProgSupp_0970-0531_7.6.22.pdf NOA - ORR SOT Medical Care Survey GenIC IC Document

Information Collection (IC) Details

IC Title:	Services for Survivors of Torture Medical Care Survey	Agency IC Tracking Number:	ORR

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			ORR-SOT Program_Medical Care Survey_2022_Final_OMB_clean.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: 35	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 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	23	23
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA - ORR SOT Medical Care Survey GenIC	ORR-SOT Medical Care Survey SSA - Formative for ACF Program Support_6.28.22.docx	07/11/2022
NOA - ORR SOT Medical Care Survey GenIC	NOA_ORR SOT Form GenIC ProgSupp_0970-0531_7.6.22.pdf	07/11/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.