Services for Unaccompanied Alien Children with Disabilities

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form S-25 Individual 504 Service Plan	Form and Instruction	Unchanged	Repair queued
Form S-25 Individual 504 Service Plan (Form S-25) – Care Provider Case Manager	Form and Instruction	Unchanged	Repair queued
Form S-25 Individual 504 Service Plan	Form and Instruction	Unchanged	Repair queued
Form S-25 Individual 504 Service Plan (Form S-25) – Child	Form and Instruction	Unchanged	Repair queued
Nonsub Memo_0970-0643_Disabilities_002_DRAFT (10.14.25).docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-10-28	Repair queued
ORR-6 0970-0036 Supporting Statement 3-year renew req_7.13.22.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-10-23	Available
Attachment A - Individualized Section 504 Service Plan (Form S-25) Appendix Crosswalk (10.14.25).xlsx	Supplementary Document	Uploaded 2025-10-15	Repair queued
Attachment A - Individualized Section 504 Service Plan (Form S-25) Appendix Crosswalk (10.14.25).xlsx	Supplementary Document	Uploaded 2025-10-15	Repair queued
Individualized Section 504 Service Plan (Form S-25) Appendix (aka Disabilities Diagnosis Report) (10.14.25).docx	Supplementary Document	Uploaded 2025-10-15	Available
Individualized Section 504 Service Plan (Form S-25) Appendix (aka Disabilities Diagnosis Report) (10.14.25).docx	Supplementary Document	Uploaded 2025-10-15	Repair queued
SSA Attachment A_0970-NEW_Disabilities_001_CLEAN + OGC_SH_ FINAL.docx	Supplementary Document	Uploaded 2025-04-11	Repair queued
SSA Attachment A_0970-NEW_Disabilities_001_CLEAN + OGC_SH_ FINAL.docx	Supplementary Document	Uploaded 2025-04-11	Repair queued
SSA_0970-0643_Disabilities_10.15.25 CLEAN.docx	Supporting Statement A	Uploaded 2025-10-15	Available
SSA_0970-0643_Disabilities_10.15.25 CLEAN.docx	Supporting Statement A	Uploaded 2025-10-15	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
274814	Individual 504 Service Plan (Form S-25) – Care Provider Case Manager	Form and Instruction	Unchanged	Individual 504 Service Plan
274814	Individual 504 Service Plan (Form S-25) – Care Provider Case Manager	Form and Instruction	Unchanged
274813	Individual 504 Service Plan (Form S-25) – Child	Form and Instruction	Unchanged	Individual 504 Service Plan
274813	Individual 504 Service Plan (Form S-25) – Child	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0970-0643	ICR Reference No: 202509-0970-007
Status: Historical Active	Previous ICR Reference No: 202504-0970-003
Agency/Subagency: HHS/ACF	Agency Tracking No: ORR - UAC Bureau
Title: Services for Unaccompanied Alien Children with Disabilities
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/28/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/23/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2028	06/30/2028	06/30/2028
Responses	4,100	0	4,100
Time Burden (Hours)	10,300	0	10,300
Cost Burden (Dollars)	0	0	0

---

Abstract: The Services for Unaccompanied Alien Children (UAC) with Disabilities information collection contains one instrument that allows the Office of Refugee Resettlement (ORR) to provide individualized care to children identified as having a disability. The collection was last approved by OMB on June 11, 2025 and the current expiration date is June 30, 2028. ORR is proposing revisions to the Individualized Section 504 Service Plan (Form S-25). This plan is required by the Lucas R. Disabilities Settlement Agreement (Case No. 2:18-CV-05741 DMG PLA). The form is completed by care providers alongside a qualified assessment team who collaboratively develop an individualized plan for the child. In addition, care providers must continuously update this form to reflect any changes in the service plan and to provide updates on the progress of the home study and post-release services planning.

---

Authorizing Statute(s): US Code: 8 USC 1232 Name of Law: William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008 (TVPRA)
   US Code: 6 USC 279 Name of Law: Homeland Security Act (HSA)
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 60428	07/25/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 17823	04/29/2025
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Individual 504 Service Plan (Form S-25) – Care Provider Case Manager	S-25	Individual 504 Service Plan
Individual 504 Service Plan (Form S-25) – Child	S-25	Individual 504 Service Plan

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	4,100	4,100	0	0	0	0
Annual Time Burden (Hours)	10,300	10,300	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection.

---

Annual Cost to Federal Government: $577,249

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/23/2025

---