OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Services Provided to Unaccompanied Children

ICR 202402-0970-011 · OMB 0970-0553 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1 UC Case Status Form and Instruction Modified Repair queued
Form 1 UC Case Status Form and Instruction Modified Repair queued
Form S-24 Sponsor Application (Form S-24) Form and Instruction Unchanged Repair queued
Form S-24 Sponsor Application (Form S-24) Form and Instruction Unchanged Repair queued
Form S-23 Case Manager Call Log and Case Notes (Form S-23) Form and Instruction Unchanged Repair queued
Form S-23 Case Manager Call Log and Case Notes (Form S-23) Form and Instruction Unchanged Repair queued
Form S-22 Post-Release Service (PRS) Event (Form S-22) Form and Instruction Unchanged Available
Form S-22 Post-Release Service (PRS) Event (Form S-22) Form and Instruction Unchanged Repair queued
Form S-21D Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D) Form and Instruction Unchanged Repair queued
Form S-21D Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D) Form and Instruction Unchanged Repair queued
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C) Form and Instruction Unchanged Available
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C) Form and Instruction Unchanged Repair queued
Form S-21B Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B) Form and Instruction Unchanged Repair queued
Form S-21B Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B) Form and Instruction Unchanged Repair queued
Form S-21A Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A) Form and Instruction Unchanged Repair queued
Form S-21A Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A) Form and Instruction Unchanged Repair queued
Form S-20 UC Authorized/Restricted Call List and Call Log (Form S-20) Form and Instruction Unchanged Repair queued
Form S-20 UC Authorized/Restricted Call List and Call Log (Form S-20) Form and Instruction Unchanged Repair queued
Form S-19 Home Study/Post-Release Service (HS/PRS) Referral (Form S-19) Form and Instruction Unchanged Repair queued
Form S-19 Home Study/Post-Release Service (HS/PRS) Referral (Form S-19) Form and Instruction Unchanged Repair queued
Form S-18 Admission (Form S-18) Form and Instruction Unchanged Repair queued
Form S-18 Admission (Form S-18) Form and Instruction Unchanged Repair queued
Form S-15 Child Advocate Recommendation and Appointment (Form S-15) Form and Instruction Unchanged Repair queued
Form S-15 Child Advocate Recommendation and Appointment (Form S-15) Form and Instruction Unchanged Repair queued
Form S-14 Long Term Foster Care Travel Request (Form S-14) Form and Instruction Unchanged Available
Form S-14 Long Term Foster Care Travel Request (Form S-14) Form and Instruction Unchanged Repair queued
Form S-13 Individual Service Plan (Form S-13) Form and Instruction Unchanged Repair queued
Form S-13 Individual Service Plan (Form S-13) Form and Instruction Unchanged Repair queued
Form S-12 UC Case Review (Form S-12) Form and Instruction Unchanged Repair queued
Form S-12 UC Case Review (Form S-12) Form and Instruction Unchanged Repair queued
Form S-11 UC Assessment (Form S-11) Form and Instruction Unchanged Available
Form S-11 UC Assessment (Form S-11) Form and Instruction Unchanged Repair queued
Form S-9 Assessment for Risk (Form S-9) Form and Instruction Unchanged Repair queued
Form S-9 Assessment for Risk (Form S-9) Form and Instruction Unchanged Repair queued
Form S-8 Initial Intakes Assessment (Form S-8) Form and Instruction Unchanged Repair queued
Form S-8 Initial Intakes Assessment (Form S-8) Form and Instruction Unchanged Repair queued
Form S-7 Adult Contact Profile (Portal Form S-5; Path Form S-7) Form and Instruction Unchanged Repair queued
Form S-7 Adult Contact Profile (Portal Form S-5; Path Form S-7) Form and Instruction Unchanged Repair queued
Form S-6 Home Study Assessment (Form S-6) Form and Instruction Unchanged Repair queued
Form S-6 Home Study Assessment (Form S-6) Form and Instruction Unchanged Repair queued
Form S-5 Sponsor Assessment (Form S-5) Form and Instruction Unchanged Available
Form S-5 Sponsor Assessment (Form S-5) Form and Instruction Unchanged Repair queued
Nonsub Memo_0970-0553_Services_009_2023 09 271.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-02-22 Repair queued
Nonsub Memo_0970-0553_Services_009_2023 09 271.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-02-22 Repair queued
Nonsub Memo_0970-0553_Services_007 _2023 10 26.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-10-26 Available
Nonsub Memo_0970-0553_Services_007 _2023 10 26.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-10-26 Repair queued
Nonsub Memo_0970-0553_Services_008 _2023 09 25.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-09-25 Repair queued
Nonsub Memo_0970-0553_Services_008 _2023 09 25.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-09-25 Repair queued
Nonsub Memo_0970-0553_Services_006 _2023 07 25.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-07-25 Repair queued
Nonsub Memo_0970-0553_Services_006 _2023 07 25.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-07-25 Missing upstream
Appendix B - S-5 Sponsor Assessment - Flags Section Mockup.pdf Supplementary Document Uploaded 2023-07-25 Repair queued
Appendix B - S-5 Sponsor Assessment - Flags Section Mockup.pdf Supplementary Document Uploaded 2023-07-25 Repair queued
Appendix A - Proposed Revisions for S-5 Sponsor Assessment - Flags Section.xlsx Supplementary Document Uploaded 2023-07-25 Repair queued
Appendix A - Proposed Revisions for S-5 Sponsor Assessment - Flags Section.xlsx Supplementary Document Uploaded 2023-07-25 Repair queued
0970-0553_Services_NonSub Change Request _UC Case Status_2022 05 23.docx Justification for No Material/Nonsubstantive Change Uploaded 2022-06-09 Repair queued
0970-0553_Services_NonSub Change Request _UC Case Status_2022 05 23.docx Justification for No Material/Nonsubstantive Change Uploaded 2022-06-09 Repair queued
0970-0553 NonSub Change Request Memo (04.21.22).docx Justification for No Material/Nonsubstantive Change Uploaded 2022-04-22 Repair queued
0970-0553 NonSub Change Request Memo (04.21.22).docx Justification for No Material/Nonsubstantive Change Uploaded 2022-04-22 Repair queued
SSA Attachment A_0970-0553_Services_003_2022 04 20.docx Supplementary Document Uploaded 2022-04-20 Available
SSA Attachment A_0970-0553_Services_003_2022 04 20.docx Supplementary Document Uploaded 2022-04-20 Repair queued
SSA_0970-0553_Services_003_2022 4 22 UPDATED.docx Supporting Statement A Uploaded 2022-04-22 Available
SSA_0970-0553_Services_003_2022 4 22 UPDATED.docx Supporting Statement A Uploaded 2022-04-22 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
249583 UC Case Status Form and Instruction Modified
249583 UC Case Status Form and Instruction Modified
249581 Sponsor Application (Form S-24) Form and Instruction Unchanged
249581 Sponsor Application (Form S-24) Form and Instruction Unchanged
249580 Case Manager Call Log and Case Notes (Form S-23) Form and Instruction Unchanged
249580 Case Manager Call Log and Case Notes (Form S-23) Form and Instruction Unchanged
249579 Post-Release Service (PRS) Event (Form S-22) Form and Instruction Unchanged
249579 Post-Release Service (PRS) Event (Form S-22) Form and Instruction Unchanged
249578 Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D) Form and Instruction Unchanged
249578 Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D) Form and Instruction Unchanged
249577 Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C) Form and Instruction Unchanged
249577 Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C) Form and Instruction Unchanged
249576 Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B) Form and Instruction Unchanged
249576 Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B) Form and Instruction Unchanged
249575 Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A) Form and Instruction Unchanged
249575 Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A) Form and Instruction Unchanged
249574 UC Authorized/Restricted Call List and Call Log (Form S-20) Form and Instruction Unchanged
249574 UC Authorized/Restricted Call List and Call Log (Form S-20) Form and Instruction Unchanged
249573 Home Study/Post-Release Service (HS/PRS) Referral (Form S-19) Form and Instruction Unchanged
249573 Home Study/Post-Release Service (HS/PRS) Referral (Form S-19) Form and Instruction Unchanged
242815 Admission (Form S-18) Form and Instruction Unchanged
242815 Admission (Form S-18) Form and Instruction Unchanged
242813 Child Advocate Recommendation and Appointment (Form S-15) Form and Instruction Unchanged
242813 Child Advocate Recommendation and Appointment (Form S-15) Form and Instruction Unchanged
242812 Long Term Foster Care Travel Request (Form S-14) Form and Instruction Unchanged
242812 Long Term Foster Care Travel Request (Form S-14) Form and Instruction Unchanged
242811 Individual Service Plan (Form S-13) Form and Instruction Unchanged
242811 Individual Service Plan (Form S-13) Form and Instruction Unchanged
242810 UC Case Review (Form S-12) Form and Instruction Unchanged
242810 UC Case Review (Form S-12) Form and Instruction Unchanged
242809 UC Assessment (Form S-11) Form and Instruction Unchanged
242809 UC Assessment (Form S-11) Form and Instruction Unchanged
242808 Assessment for Risk (Form S-9) Form and Instruction Unchanged
242808 Assessment for Risk (Form S-9) Form and Instruction Unchanged
242807 Initial Intakes Assessment (Form S-8) Form and Instruction Unchanged
242807 Initial Intakes Assessment (Form S-8) Form and Instruction Unchanged
242806 Adult Contact Profile (Portal Form S-5; Path Form S-7) Form and Instruction Unchanged
242806 Adult Contact Profile (Portal Form S-5; Path Form S-7) Form and Instruction Unchanged
242805 Home Study Assessment (Form S-6) Form and Instruction Unchanged
242805 Home Study Assessment (Form S-6) Form and Instruction Unchanged
242804 Sponsor Assessment (Form S-5) Form and Instruction Unchanged
242804 Sponsor Assessment (Form S-5) Form and Instruction Unchanged
ICR Details
StatusActive
Agency/SubagencyHHS/ACF
OMB Control No0970-0553
Type of Information CollectionNo material or nonsubstantive change to a currently approved collection
Previous ICR Reference No202310-0970-013
Agency Tracking NoORR
Date Submitted to OIRA2024-02-23
Requested Expiration Date1969-12-31