UAC Assessment (S-11) - Clinician

Unaccompanied Alien Children Assessments for Children and Sponsors

Documents and Forms

Document Name Document Type
Form S-11 UAC Assessment (S-11) - Clinician 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

Information Collection (IC) Details

IC Title:	UAC Assessment (S-11) - Clinician	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
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		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 %

	Requested	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

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.