Information Collection

Safety and Well-Being Call (R-6) - Modernized UC Portal - PRS Provider

IC 264195 under ICR 202401-0970-003 · OMB 0970-0552.

Documents and Forms

Document Name Document Type
Form R-6 Safety and Well-Being Call (R-6) - Modernized UC Portal - PRS Provider Form and Instruction
R-6 Safety and Well-Being Call Report - Modernized UC Portal Virtual Check-In Questionnaire (Form R-6).docx Form and Instruction
R-6 Safety and Well-Being Call Report - Modernized UC Portal Virtual Check-In Questionnaire (Form R-6).docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Safety and Well-Being Call (R-6) - Modernized UC Portal - PRS Provider	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	R-6	Safety and Well-Being Call Report - Modernized UC Portal	Virtual Check-In Questionnaire (Form R-6).docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: 09-80-0321 ORR Division of Children's Services Records	FR Citation: 81 FR 46682

Number of Respondents: 40	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: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	770,920	770,920
Annual IC Time Burden (Hours)	447,134	447,134
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.