Information Collection

Notice of Placement in a Restrictive Setting (Form P-4)

IC 242789 under ICR 202407-0970-012 · OMB 0970-0554.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0554 can be found here:

Documents and Forms

Document Name Document Type
Form P-4 Notice of Placement in a Restrictive Setting (Form P-4) Form and Instruction
P-4 Notice of Placement in a Restrictive Setting (English) Notice of Placement in a Restrictive Setting (Form P-4) English.pdf Form and Instruction
P-4 Notice of Placement in a Restrictive Setting (English) Notice of Placement in a Restrictive Setting (Form P-4) English.pdf Form and Instruction
P-4 (ESP) Notice of Placement in a Restrictive Setting (Spanish) TR109_P-4 (ESP) Notice of Placement in a Restrictive Setting_v6_Spanish_DRAFT.docx Form and Instruction
P-4 (ESP) Notice of Placement in a Restrictive Setting (Spanish) TR109_P-4 (ESP) Notice of Placement in a Restrictive Setting_v6_Spanish_DRAFT.docx Form and Instruction
P-4 (PRS) Notice of Placement in a Restrictive Setting (Dari) TR109_P-4 (PRS) Notice of Placement in a Restrictive Setting_v6_Dari Persian_DRAFT.docx Form and Instruction
P-4 (PRS) Notice of Placement in a Restrictive Setting (Dari) TR109_P-4 (PRS) Notice of Placement in a Restrictive Setting_v6_Dari Persian_DRAFT.docx Form and Instruction
P-4 (PUS) Notice of Placement in a Restrictive Setting (Pashto) TR109_P-4 (PUS) Notice of Placement in a Restrictive Setting_v6_Pashto_DRAFT.docx Form and Instruction
P-4 (PUS) Notice of Placement in a Restrictive Setting (Pashto) TR109_P-4 (PUS) Notice of Placement in a Restrictive Setting_v6_Pashto_DRAFT.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Notice of Placement in a Restrictive Setting (Form P-4)	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	P-4	Notice of Placement in a Restrictive Setting (English)	Notice of Placement in a Restrictive Setting (Form P-4) English.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	P-4 (ESP)	Notice of Placement in a Restrictive Setting (Spanish)	TR109_P-4 (ESP) Notice of Placement in a Restrictive Setting_v6_Spanish_DRAFT.docx	Yes	Yes	Fillable Fileable
Form and Instruction	P-4 (PRS)	Notice of Placement in a Restrictive Setting (Dari)	TR109_P-4 (PRS) Notice of Placement in a Restrictive Setting_v6_Dari Persian_DRAFT.docx	Yes	Yes	Fillable Fileable
Form and Instruction	P-4 (PUS)	Notice of Placement in a Restrictive Setting (Pashto)	TR109_P-4 (PUS) Notice of Placement in a Restrictive Setting_v6_Pashto_DRAFT.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: 15	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: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,710	1,710
Annual IC Time Burden (Hours)	564	564
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.