Incident Reviews (Forms M-5A to M-5B)

Monitoring and Compliance for Office of Refugee Resettlement (ORR) Care Provider Facilities

Documents and Forms

Document Name Document Type
Form Form M-5A Incident Reviews (Forms M-5A to M-5B) Form and Instruction
Form Form M-5A Incident Reviews (Forms M-5A to M-5B) Form and Instruction
Form M-5A Incident Review M-5A PSA UC Incident Review.pdf Form and Instruction
Form M-5A Incident Review M-5A PSA UC Incident Review.pdf Form and Instruction
Form M-5B Adult Incident Review M-5B PSA Adult Incident Review.pdf Form and Instruction
Form M-5B Adult Incident Review M-5B PSA Adult Incident Review.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Incident Reviews (Forms M-5A to M-5B)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	Form M-5A	Incident Review	M-5A PSA UC Incident Review.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	Form M-5B	Adult Incident Review	M-5B PSA Adult Incident Review.pdf		Yes	Yes	Fillable Fileable

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: 262	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	Previously Approved
Annual Number of Responses for this IC	79	79
Annual IC Time Burden (Hours)	118	118
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.