Emergency Significant Incident Report (Form A-9B)

Incident Reporting for the Unaccompanied Alien Children Bureau

Documents and Forms

Document Name Document Type
Form A-9B Emergency Significant Incident Report (Form A-9B) Form and Instruction
A-9B Emergency Significant Incident Report Emergency Significant Incident Report (Form A-9B)_2025 04 17.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Emergency Significant Incident Report (Form A-9B)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 410, 411, 412 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	A-9B	Emergency Significant Incident Report	Emergency Significant Incident Report (Form A-9B)_2025 04 17.pdf		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: ORR Unaccompanied Children Bureau 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: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	4,500	4,500
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.