Information Collection

Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)

IC 249577 under ICR 202504-0970-004 · OMB 0970-0553.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0553 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)	Form and Instruction
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)	Form and Instruction
S-21C Home Study/Post-Release Service (HS/PRS) Primary Provide HS-PRS Primary Provider Profile (Form S-21C) - UC Path.pdf	Form and Instruction
S-21C Home Study/Post-Release Service (HS/PRS) Primary Provide HS-PRS Primary Provider Profile (Form S-21C) - UC Path.pdf	Form and Instruction

IC Title:

Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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-21C				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 46882

Number of Respondents: 9

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 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-117	117
Annual IC Time Burden (Hours)	-9	9
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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