Information Collection

Unaccompanied Child Questionnaires (Forms M-12A to M-12B & M-12E) - Respondents

IC 245614 under ICR 202305-0970-015 · OMB 0970-0564.

⚠️ Notice: This information collection may be referencing outdated material.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

2024-03-22 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Document Name Document Type
Form Form M-12A Unaccompanied Child Questionnaires (Forms M-12A to M-12B & M-12E) - Respondents Form and Instruction
Form M-12A UC Questionnaire - Ages 6-12 Years Old - English M-12A UC Questionnaire - Ages 6-12 Years Old - Clean.docx Form and Instruction
Form M-12A UC Questionnaire - Ages 6-12 Years Old - English M-12A UC Questionnaire - Ages 6-12 Years Old - Clean.docx Form and Instruction
Form M-12B UC Questionnaire - Ages 13 and Older - English M-12B UC Questionnaire - Ages 13 and Older - Clean.docx Form and Instruction
Form M-12B UC Questionnaire - Ages 13 and Older - English M-12B UC Questionnaire - Ages 13 and Older - Clean.docx Form and Instruction
Form M-12E UC Questionnaire - Ages 5 and Under - English UC Questionnaire - Ages 5 and Under - English (Form M-12E).docx Form and Instruction
Form M-12E UC Questionnaire - Ages 5 and Under - English UC Questionnaire - Ages 5 and Under - English (Form M-12E).docx Form and Instruction
Form M-12As UC Questionnaire - Ages 6-12 Years Old - Spanish M-12As UC Questionnaire - Ages 6-12 Years Old Spanish .docx Form and Instruction
Form M-12As UC Questionnaire - Ages 6-12 Years Old - Spanish M-12As UC Questionnaire - Ages 6-12 Years Old Spanish .docx Form and Instruction
Form M-12Bs UC Questionnaire - Ages 13 and Older - Spanish M-12Bs UC Questionnaire - Ages 13 and Older Spanish .docx Form and Instruction
Form M-12Bs UC Questionnaire - Ages 13 and Older - Spanish M-12Bs UC Questionnaire - Ages 13 and Older Spanish .docx Form and Instruction
Form M-12Es UC Questionnaire - Ages 5 and Under - Spanish UC Questionnaire - Ages 5 and Under - Spanish (Form M-12Es).docx Form and Instruction
Form M-12Es UC Questionnaire - Ages 5 and Under - Spanish UC Questionnaire - Ages 5 and Under - Spanish (Form M-12Es).docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Unaccompanied Child Questionnaires (Forms M-12A to M-12B & M-12E) - Respondents	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form M-12A	UC Questionnaire - Ages 6-12 Years Old - English	M-12A UC Questionnaire - Ages 6-12 Years Old - Clean.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Form M-12B	UC Questionnaire - Ages 13 and Older - English	M-12B UC Questionnaire - Ages 13 and Older - Clean.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Form M-12E	UC Questionnaire - Ages 5 and Under - English	UC Questionnaire - Ages 5 and Under - English (Form M-12E).docx	Yes	Yes	Fillable Fileable
Form and Instruction	Form M-12As	UC Questionnaire - Ages 6-12 Years Old - Spanish	M-12As UC Questionnaire - Ages 6-12 Years Old Spanish .docx	Yes	Yes	Fillable Fileable
Form and Instruction	Form M-12Bs	UC Questionnaire - Ages 13 and Older - Spanish	M-12Bs UC Questionnaire - Ages 13 and Older Spanish .docx	Yes	Yes	Fillable Fileable
Form and Instruction	Form M-12Es	UC Questionnaire - Ages 5 and Under - Spanish	UC Questionnaire - Ages 5 and Under - Spanish (Form M-12Es).docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: ORR Unaccompanied Refugee Minors Records	FR Citation: 81 FR 46682

Number of Respondents: 563	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	563	103	460
Annual IC Time Burden (Hours)	282	52	230
Annual IC Cost Burden (Dollars)	0	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.