Information Collection

Individual 504 Service Plan (Form S-25) – Child

IC 274813 under ICR 202504-0970-003 · OMB 0970-0643.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0643 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form S-25 Individual 504 Service Plan (Form S-25) – Child	Form and Instruction
Form S-25 Individual 504 Service Plan Individual 504 Service Plan (Form S-25) – Child	Form and Instruction
S-25 Individual 504 Service Plan S-25 Individualized Section 504 Service Plan_Final Draft_2025 03 06.pdf	Form and Instruction
S-25 Individual 504 Service Plan S-25 Individualized Section 504 Service Plan_Final Draft_2025 03 06.pdf	Form and Instruction

IC Title:

Individual 504 Service Plan (Form S-25) â Child

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	S-25				Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title: ORR Unaccompanied Children Bureau (UCB) Administrative Program Records

FR Citation: 89 FR 100500

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	4,000	4,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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