OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Office of Refugee Resettlement (ORR) Care Provider Healthcare Delivery Report (HDR)

IC 275792 under ICR 202604-0970-004 · OMB 0970-0558.

Documents and Forms
Document Name
Document Type
Form
Form
Form
Form
IC Document
IC Document
Information Collection (IC) Details

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Office of Refugee Resettlement (ORR) Care Provider Healthcare Delivery Report (HDR) ORR-UACB
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 ORR HDR TAB A_ORR Care Provider Healthcare Delivery Report_Final_6.16.25.xlsx Yes Yes Fillable Fileable

Community and Social Services Social Services

 

225 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 225 0 0 0 0 225
Annual IC Time Burden (Hours) 338 0 0 0 0 338
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Monitoring GenIC - ORR Care Provider HDR Submission for Monitoring Generic _0970-0558_ORR Care Provider HDR_6.16.25.docx 06/16/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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