Information Collection Request

Services for Unaccompanied Alien Children with Disabilities

ICR 202504-0970-003 · OMB 0970-0643 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form S-25 Individual 504 Service Plan Form and Instruction New Available
Form S-25 Individual 504 Service Plan (Form S-25) – Care Provider Case Manager Form and Instruction New Repair queued
Form S-25 Individual 504 Service Plan Form and Instruction New Available
Form S-25 Individual 504 Service Plan (Form S-25) – Child Form and Instruction New Repair queued
2025.05.23 Lucas R. Counsel Comment re Sec 504 Service Plan.pdf Public Comments Uploaded 2025-05-23 Available
Lucas R. Counsel Comment re Sec 504 Service Plan Form_Mishan Wroe_email 9.18.24.pdf Public Comments Uploaded 2024-09-18 Available
SSA Attachment A_0970-NEW_Disabilities_001_CLEAN + OGC_SH_ FINAL.docx Supplementary Document Uploaded 2025-04-11 Repair queued
SSA Attachment A_0970-NEW_Disabilities_001_CLEAN + OGC_SH_ FINAL.docx Supplementary Document Uploaded 2025-04-11 Repair queued
SSA_0970-NEW_Disabilities_001- OGC Updated_LD_bg_SH_FINAL.docx Supporting Statement A Uploaded 2025-04-11 Repair queued
SSA_0970-NEW_Disabilities_001- OGC Updated_LD_bg_SH_FINAL.docx Supporting Statement A Uploaded 2025-04-11 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
274814 Individual 504 Service Plan (Form S-25) – Care Provider Case Manager Form and Instruction NewIndividual 504 Service Plan
274814 Individual 504 Service Plan (Form S-25) – Care Provider Case Manager Form and Instruction New
274813 Individual 504 Service Plan (Form S-25) – Child Form and Instruction NewIndividual 504 Service Plan
274813 Individual 504 Service Plan (Form S-25) – Child Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
06/30/2028 36 Months From Approved
4,100 0 0
10,300 0 0
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Individual 504 Service Plan (Form S-25) – Care Provider Case Manager S-25
Individual 504 Service Plan (Form S-25) – Child S-25

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,100 0 0 4,100 0 0
Annual Time Burden (Hours) 10,300 0 0 10,300 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No