Information Collection

Refugee Support Services Youth Mentoring Set-Aside Programs Assessment Guides

IC 270269 under ICR 202408-0970-005 · OMB 0970-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Document Name Document Type
1 - SURVEY_YM Local Provider.docx Other-Survey
2- QUEST_YM SRC Interview.docx Other-Interview Protocol
3 - QUEST_YM Client Questionnaire.docx Other-Questionnaire
4 - QUEST_YM Local Provider Guide.docx Other-Guide
5 - QUEST_YM Mentor Questionnaire.docx Other-Questionnaire
SSA_RSS Set Asides Assessment_Formative Prog Support_YM_8.20.2024_updated.docx SSA - Refugee Support Services Youth Mentoring Set-Aside Programs Assessment Guides IC Document
Letter_YM Client Invitation and Consent_ENGLISH.docx Consent - RSS YM Set-Aside Programs Assessment Guides IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Refugee Support Services Youth Mentoring Set-Aside Programs Assessment Guides	Agency IC Tracking Number:	ORR-Ref

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	1 - SURVEY_YM Local Provider.docx	Yes	Yes	Fillable Fileable
Other-Interview Protocol	2- QUEST_YM SRC Interview.docx	Yes	Yes	Printable Only
Other-Questionnaire	3 - QUEST_YM Client Questionnaire.docx	Yes	Yes	Fillable Fileable
Other-Guide	4 - QUEST_YM Local Provider Guide.docx	Yes	Yes	Printable Only
Other-Questionnaire	5 - QUEST_YM Mentor Questionnaire.docx	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 215	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	215	215
Annual IC Time Burden (Hours)	132	132
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA - Refugee Support Services Youth Mentoring Set-Aside Programs Assessment Guides	SSA_RSS Set Asides Assessment_Formative Prog Support_YM_8.20.2024_updated.docx	08/20/2024
Consent - RSS YM Set-Aside Programs Assessment Guides	Letter_YM Client Invitation and Consent_ENGLISH.docx	08/20/2024

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