Information Collection Request

Administration and Oversight of the Unaccompanied Children Program

ICR 202304-0970-003 · OMB 0970-0547 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Form A-7 Notification of Concern Form Modified Repair queued
Form Form A-7 Notification of Concern (Form A-7) Form Modified Repair queued
Form A-5s Authorization for Release of Records - Spanish Form Unchanged Available
Form A-5 Authorization for Release of Records Form Unchanged Available
Form A-5 Authorization for Release of Records (Form A-5 & A-5s) - Record keeping Form Unchanged Repair queued
Form Form A-1A Care Provider Facility Tour Request Form Unchanged Available
Form Form A-1A Care Provider Facility Tour Request (Form A-1A) - Record Keeping Form Unchanged Available
Form Form A-15 ORR Waiver Request Form Unchanged Available
Form Form A-15 ORR Waiver Request (Form A-15) Form Unchanged Repair queued
Form A-14 Key Personnel Qualification Checklist and Attestation Form Unchanged Available
Form A-14 Key Personnel Minimum Qualifications Checklist and Attestation (Form A-14) Form Unchanged Repair queued
Form A-10D Program-Level Event Report and Addendum - UC Path Version Form Unchanged Available
Form A-10D Program-Level Event Report - UC Portal Version Form Unchanged Available
Form A-10D Program Level Event (Form A-10D) Form Unchanged Repair queued
Form A-10C Significant Incident Report - UC Portal Version Form Unchanged Repair queued
Form A-10C Significant Incident Report - UC Path Version Form Unchanged Available
Form A-10C Significant Incident Report (Form A-10C) Form Unchanged Repair queued
Form A-10B Emergency Significant Incident Report Addendum - UC Portal Version Form Unchanged Available
Form A-10B Emergency Significant Incident Report Addendum - UC Path Version Form Unchanged Repair queued
Form A-10B Emergency Significant Incident Report Addendum (Form A-10B) Form Unchanged Repair queued
Form A-10A Emergency SIR and Addendum - UC Portal Version Form Unchanged Available
Form A-10A Emergency Significant Incident Report - UC Path Version Form Unchanged Available
Form A-10A Emergency Significant Incident Report (Form A-10A) Form Unchanged Repair queued
Form A-9 Event Report Form Unchanged Available
Form A-9 Event (Form A-9) Form Unchanged Repair queued
Form A-5s Authorization for Release of Records - Spanish Form Unchanged Available
Form A-5 Authorization for Release of Records Form Unchanged Available
Form A-5 Authorization for Release of Records (Form A-5 & A-5s) Form Unchanged Repair queued
Form A-4s Notice to UC for Flores Visits - Spanish Form Unchanged Available
Form A-4 Notice to UC for Flores Visits Form Unchanged Available
Form A-4 Notice to UAC for Flores Visits (Forms A-4 & A-4s) Form Unchanged Repair queued
Form A-1A Care Provider Facility Tour Request Form Unchanged Available
Form A-1A Care Provider Facility Tour Request (Form A-1A) Form Unchanged Repair queued
Nonsub Memo_0970-0547_Admin and Oversight_004_2023 04 11.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-04-11 Available
Nonsub Memo_0970-0547_Admin and Oversight_004_2023 04 11.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-04-11 Repair queued
Attachment A - Admin and Oversight (05.10.22) clean.docx Supplementary Document Uploaded 2022-05-16 Available
Attachment A - Admin and Oversight (05.10.22) clean.docx Supplementary Document Uploaded 2022-05-16 Repair queued
Supporting Statement - Admin and Oversight (05.10.22) clean.docx Supporting Statement A Uploaded 2022-05-16 Available
Supporting Statement - Admin and Oversight (05.10.22) clean.docx Supporting Statement A Uploaded 2022-05-16 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
249481 Notification of Concern (Form A-7) Form ModifiedNotification of Concern
249481 Notification of Concern (Form A-7) Form Modified
249480 Authorization for Release of Records (Form A-5 & A-5s) - Record keeping Form UnchangedAuthorization for Release of Records - Spanish
249480 Authorization for Release of Records (Form A-5 & A-5s) - Record keeping Form UnchangedAuthorization for Release of Records
249480 Authorization for Release of Records (Form A-5 & A-5s) - Record keeping Form Unchanged
241082 Care Provider Facility Tour Request (Form A-1A) - Record Keeping Form UnchangedCare Provider Facility Tour Request
241082 Care Provider Facility Tour Request (Form A-1A) - Record Keeping Form Unchanged
241079 ORR Waiver Request (Form A-15) Form UnchangedORR Waiver Request
241079 ORR Waiver Request (Form A-15) Form Unchanged
241078 Key Personnel Minimum Qualifications Checklist and Attestation (Form A-14) Form UnchangedKey Personnel Qualification Checklist and Attestation
241078 Key Personnel Minimum Qualifications Checklist and Attestation (Form A-14) Form Unchanged
241077 Program Level Event (Form A-10D) Form UnchangedProgram-Level Event Report and Addendum - UC Path Version
241077 Program Level Event (Form A-10D) Form UnchangedProgram-Level Event Report - UC Portal Version
241077 Program Level Event (Form A-10D) Form Unchanged
241076 Significant Incident Report (Form A-10C) Form UnchangedSignificant Incident Report - UC Portal Version
241076 Significant Incident Report (Form A-10C) Form UnchangedSignificant Incident Report - UC Path Version
241076 Significant Incident Report (Form A-10C) Form Unchanged
241075 Emergency Significant Incident Report Addendum (Form A-10B) Form UnchangedEmergency Significant Incident Report Addendum - UC Portal Version
241075 Emergency Significant Incident Report Addendum (Form A-10B) Form UnchangedEmergency Significant Incident Report Addendum - UC Path Version
241075 Emergency Significant Incident Report Addendum (Form A-10B) Form Unchanged
241074 Emergency Significant Incident Report (Form A-10A) Form UnchangedEmergency SIR and Addendum - UC Portal Version
241074 Emergency Significant Incident Report (Form A-10A) Form UnchangedEmergency Significant Incident Report - UC Path Version
241074 Emergency Significant Incident Report (Form A-10A) Form Unchanged
241073 Event (Form A-9) Form UnchangedEvent Report
241073 Event (Form A-9) Form Unchanged
241072 Authorization for Release of Records (Form A-5 & A-5s) Form UnchangedAuthorization for Release of Records - Spanish
241072 Authorization for Release of Records (Form A-5 & A-5s) Form UnchangedAuthorization for Release of Records
241072 Authorization for Release of Records (Form A-5 & A-5s) Form Unchanged
241070 Notice to UAC for Flores Visits (Forms A-4 & A-4s) Form UnchangedNotice to UC for Flores Visits - Spanish
241070 Notice to UAC for Flores Visits (Forms A-4 & A-4s) Form UnchangedNotice to UC for Flores Visits
241070 Notice to UAC for Flores Visits (Forms A-4 & A-4s) Form Unchanged
241067 Care Provider Facility Tour Request (Form A-1A) Form UnchangedCare Provider Facility Tour Request
241067 Care Provider Facility Tour Request (Form A-1A) Form Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2025 05/31/2025 05/31/2025
180,529 0 180,529
132,577 0 132,577
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 180,529 180,529 0 0 0 0
Annual Time Burden (Hours) 132,577 132,577 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No