Information Collection

UAC Assessment (S-11) - Case Manager

IC 274895 under ICR 202504-0970-010 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form S-11 UAC Assessment (S-11) - Case Manager	Form and Instruction
Form S-11 UAC Assessment UAC Assessment (S-11) - Case Manager	Form and Instruction
S-11 UAC Assessment Unaccompanied Child Assessment (Form S-11) Integrated Edits & EO Remediated v.4.0_2025.03.27 - CLEAN.docx	Form and Instruction
S-11 UAC Assessment Unaccompanied Child Assessment (Form S-11) Integrated Edits & EO Remediated v.4.0_2025.03.27 - CLEAN.docx	Form and Instruction

IC Title:

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-11				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: 300

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
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	32,400	32,400
Annual IC Time Burden (Hours)	72,900	72,900
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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