Request for Specific Consent to Juvenile Court Jurisdiction (Form L-1)

Legal and Advocacy Services for Unaccompanied Children

Documents and Forms

Document Name Document Type
Form Form L-1 Request for Specific Consent to Juvenile Court Jurisdiction (Form L-1) Form and Instruction
Form L-1 Request for Specific Consent L-1 Request for Specific Consent_v4_Final Draft - REVISED.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Request for Specific Consent to Juvenile Court Jurisdiction (Form L-1)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 45 CFR § 410.1209 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form L-1	Request for Specific Consent	L-1 Request for Specific Consent_v4_Final Draft - REVISED.pdf		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: 31	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 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	31	-9	40
Annual IC Time Burden (Hours)	8	-2	10
Annual IC Cost Burden (Dollars)	0	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.